CONTROLLING SCHOOL
ANXIETY:
A PRACTICAL GUIDE FOR
COUNSELORS AND
TEACHERS
by
David B. Ross, EdD
The College of Lake County
Grayslake, Illinois
FORWARD
As an active counselor I do my best to diligently read the monthly professional
journals that I receive. I enjoy the ideas presented and the thoroughness of the research
studies. It is with respect and envy that I decipher the statistical procedures used and
carefully scrutinize the conclusion and discussion sections. Yet all too frequently I
wonder what it means for daily practitioners. I also talk with many colleagues who don't
spend as much time as I reading the literature because they either don't have the time or
have trouble interpreting the technical procedures used.
When faced with the opportunity to spend a sabbatical leave learning more about
school anxieties and writing up my findings I thought about all the counselors who had
asked me, "Dave, if you ever write up something about all the work your are doing with
test anxiety, I would like to read it." They were looking for some "hands on, nuts and
bolts" materials, not a research project. It is not denying that the research is critical, but
that they need someone to do the translating and place it into practical terms for the
counselor to use in his or her daily practice.
I also reflect on the hundreds of students that I have seen with significant
problems functioning in school, problems that prevented them from fully achieving their
school goals and reaching for their dreams. Many of these students I was able to help,
many I could not because I couldn't give them sufficient time or couldn't figure out the
combination necessary to help them through the crisis. At the community college you see
an incredible cross-section of humanity with a vast range of skills. Some of the students
who have the greatest need to achieve in school, have the greatest barriers to hurdle. I
can recall with pride the story of the 50 year old woman who came back to school to get a
job, but was paralyzed with so much fear of evaluation that her fingers froze when she
had to take a typing test. One year later, after significant work, she was able to address a
meeting of the entire faculty and share her experiences about returning to school and the
support that she received in her enterprise. Or it is with a sense of sadness and failure
that I talked with a 30 year old man who was leaving school because his feelings of
anxiety were escalating, rather than decreasing. I don't know if he will ever return. It is
the faces of these students that I see as I learn more about school anxieties and prepare to
communicate my knowledge to others. In the text there are stories and case studies from
my students. The names and details have been changed to protect their anonymity.
This book is written for those colleagues who are seeking a practical way to help
the students they see on a daily basis. Their students deserve all the assistance that they
can get, and learning how to perform in school evaluation situations is critical to their
success. If you are looking for a detailed reference guide to conduct research with test or
other school anxieties, go directly to the literature instead. The material included is based
on a careful and complete review of the literature and 15 years of experience in working
with anxious college students of all ages. As the title implies it is a practical guide for
counselors who want to learn more about dealing with anxious students. It is written in a
manner that each chapter is reasonably self-contained so that a counselor can read and
benefit from the chapter. Also referenced in the appendix are supplementary materials
ii
used at the College of Lake County that can be purchased for use at your school. It is also
written so that you don't have to have a PhD in statistics to understand the technical
elements of the treatment. Most of the treatment methods discussed have been around for
a long time, nothing is really new. It is simply an attempt to better organize it for the
practitioner. I hope that many counselors will read sections and say, "I knew that!",
because then it will serve as a confirmation of many of the common sense ideas they are
using.
David B. Ross, EdD, NCC
The College of Lake County, Grayslake, Illinois
Fall 1990
Copywrite 1990
Duplication with permission of the author only.
iii
CONTROLLING SCHOOL ANXIETY: A PRACTICAL GUIDE FOR
COUNSELORS AND TEACHERS.
Table of Contents
Chapter One: A Definition of School Anxiety
School Anxiety Defined
General Anxiety
The Physiology of Anxiety
The Cognitive Elements of Anxiety
Summary
Selected References
Chapter Two: Assessment of School Anxiety
Types of Assessment
Sample Clinical Assessment
Standardized Anxiety Assessments
Selected References
Chapter Three: Study Skills Critical to School Anxiety
Four Problem Areas
Time Management
23
Concentrating and Remembering
Managing Test Situations
Assertiveness and Lack of Responsibility
33
Selected References
Chapter Four: Systematic Desensitization
Traditional Desensitization
In Vivo Desensitization
Audio Tape and Group Presentation
Summary
Selected References
Chapter Five: Cognitive Approaches
Skills Acquisition
Cognitive Restructuring
The Development of Coping Strategies
Summary
Selected References
Chapter Six: General Stress Management Techniques
Diet and Eating Patterns
Exercise
Managing Time and Life Pacing
Summary
Selected References
iv
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1
3
6
10
11
12
13
13
14
18
20
22
22
27
29
34
35
36
41
42
43
43
44
44
45
48
51
52
53
54
57
58
61
62
Chapter Seven: Models for Programs for Test, Speech and
Math Anxiety
Test Anxiety
Speech Anxiety or Communication Apprehension
Math Anxiety
Summary
Selected References
Persons Who Provided Information or Consultations
63
63
65
68
69
70
71
Chapter Eight: Relaxation and Desensitization Scripts
72
Conclusion
82
Bibliography
83
Materials that Can be Ordered from the College of Lake County
v
87
CHAPTER ONE
A DEFINITION OF SCHOOL ANXIETY
"I just don't know what happened. I had studied my brains out and when I got to
the test and my mind just went blank. Then my stomach started to churn. I
couldn't do anything to get going. I was able to answer a few questions, but I just
know I failed it. My teacher is going to think I'm crazy, because I always
participate in class and understand what is going on."
"It has been that way ever since I have been a little girl, I just don't have a mind
for math. I can recall having to do problems on the board in elementary school
and being embarrassed about it. Now that I am an adult I should be able to put
that behind me. But I sat there in class today and got more and more frustrated
with myself and wasn't able to listen to the teacher."
"I simply won't take that speech class, I just can't do it. My hands shake, I feel
like I am going to faint, I start sweating like I am in a sauna. Maybe I just won't
graduate and will go to another school where I don't have to take it."
Counselors in colleges and high schools hear laments like this on a daily basis.
Students who get such strong physical and emotional reactions that they simply can't
perform in an adequate manner. They may be good students, poor students, returning
adults, or almost any classification that you can think of, but they have one thing in
common: a school related anxiety that prevents them from becoming successful. That is
what this book is about.
It is a handbook for counselors and teachers who work with students who have
anxieties about being in school or completing their schoolwork. So it is prepared for all
counselors and teachers because it is impossible to be in a high school or college today
without working with anxious students. Anxiety is a normal and acceptable form of
behavior and every student has some level of anxiety. How many of us can claim that we
didn't sweat a little or have some butterflies before our first college exam? Yet for most
of us this small level of nervousness is a minor inconvenience that disappears once we get
into the task at hand. In many ways this low level of anxiety helps motivate us to work a
little harder getting prepared. However, a certain percentage of students cannot shake this
nervousness and it can overpower their ability to cope in certain situations. It can also
1
grow unchecked and take over in areas that were formerly unaffected. This is the student
with "School Anxieties."
We can operationally define "School Anxiety" by saying that it is a strong
physical and psychological reaction to specific situations in school that seriously impairs
the ability of the student to perform. Or in more practical terms, it is the student who gets
so nervous that he or she can't do well on a test, speech, class discussion, or other
performance-related activity. More frequently one will hear the terms: Test Anxiety,
Speech Anxiety (Communication Apprehension), Math Anxiety, etc. The more general
term of school anxiety has been chosen here because all of these anxieties share some
common characteristics, and treatment for one will generalize to treatment for the others.
There are, of course some major differences in the treatment strategies to be used for the
various types of school anxieties and specific suggestions will be made in Chapter 7.
To further define what is meant by a school anxiety let me illustrate by a typical case:
Andrea was a pretty good student in elementary school, but during high school
things went bad and she began to care less and less for school. At 17 and
pregnant, she left school to get married. The marriage lasted five years and left
her with custody of her son. She worked at a variety of jobs just to make ends
meet. Despite her limited education and busy schedule she read a lot and
continued her intellectual development. At 30 she decided to take a GED
preparation class because a job she wanted (real estate sales) required that she be a
high school graduate. She completed the preparation in about six months and
passed the GED exam with very high scores. Buoyed by this success and the
encouragement of her friends, Andrea enrolled part-time at the community
college, taking two business courses. She came to her "Introduction to Business"
class for the first exam, not sure if she had studied the material in the appropriate
manner. As the test started her hand began to shake and her stomach started to
feel queasy. She had trouble reading the questions and her mind went blank on a
couple of occasions. When she finally got in control she began to feel the time
pressure and her ability to perform deteriorated even more. She went home and
cried that night, not wanting to return. All of the bad feelings she had about high
school came flooding back and it took all the courage she had to go back to class
the next week to pick up the expected "F". Luckily, a sensitive professor wrote on
her test paper, "see me after class." He had noted the discrepancy between her inclass performance and the test. He referred her to the counseling center for
assistance.
Andrea quite obviously had a strong physical and psychological reaction that
prevented her from being successful on her business test--a school anxiety If the
instructor had not referred her for additional assistance, she would have been an early
semester drop-out who would take years to get up enough courage to come back to
school. Or if she had continued in school the intensity of the anxiety could grow from
additional reinforcement. From the details described above one does not have enough
information to fully prescribe a treatment plan. But for the reader's benefit, Andrea
2
responded very quickly by using some of the following and became a good student: study
skills, test-taking strategies, lifestyle management.
General Anxiety
It is useful, also, to consider some general definitions of anxiety because they help
to place school anxieties in their proper perspective. Frequently anxiety is equated to a
response to a fear producing stimuli. Wolpe (1981) in a book written for the general
public, rather than for therapists, tried to explain the difference between useful and
useless fears:
"Fears may be considered useful when they are aroused in circumstances where
there is a real threat; useless fears are aroused when there is no such threat. The
contrast is illustrated by the following example. If, walking through a park, I
come upon a snarling tiger, the fear I feel is appropriate because there is a real
danger. But if, instead of a tiger, I see a small mouse and am terrified by that
harmless creature, the fear is useless."
So in other words, we begin to overreact to certain stimuli. In terms of evolution our
bodies and minds are prepared to react to certain stimuli, mobilize our resources, and save
ourselves. Yet situations (like certain school evaluations) with only mildly threatening
elements, can generate a full blown response. Behaviorist call this process stimulus
generalization. So for some reason we have learned to anxious. Sometimes we know the
cause, other times we do not.
Beck (1985) begins a definition of anxiety by stating that fear reactions affect
nearly every system of the body: physiological, cognitive, motivational, affective or
emotional, and behavioral. Treatments must address all these different systems. He in
particular notes the cognitive elements in our anxiety reactions. How we interpret the
situation around us can lead to further arousal. Fear is the interpretation of a threatening
stimulus, while anxiety is the emotional state that results from appraisal of the stimulus.
It is also important to note that anxiety serves a useful purpose to us because it is part of
the natural arousal and protective systems of human beings that help us deal with threats.
Or another way to express this general definition is to state that fear is external
and specific, while the anxiety is ill-defined or from an unrecognized source of danger
(Greist, 1986). Anxiety describes an unpleasant state of mental (or psychological) tension
often accompanied by physical (or physiological) symptoms in which we may feel both
physically and mentally helpless, exhausted by being on guard against an unidentifiable
danger. Greist further delineated anxiety by dividing it into spontaneous anxiety,
situational anxiety, or anticipatory anxiety. A spontaneous anxiety reaction has a sudden
intense onset (such as having the teacher announce a pop-quiz), then the intensity of the
reaction gradually decreases over time. Situational anxiety only occurs in particular
situations (such as taking math tests). Anticipatory anxiety is one that is triggered merely
3
by thinking about the event (such as thinking about an upcoming test), and starts with a
low intensity and gradually builds over time. But regardless of the type of anxiety, the
person gets similar mental or physical reactions.
Another common definition of anxiety is the state and trait distinction
(Spielberger, 1983). The best way to describe State Anxiety is to say it is a "moment in
time," a temporary condition or emotional state that is usually related to a specific
situation or stimulus. For example, a usually relaxed person who is nervous about giving
a particular speech is experiencing a heightened level of state anxiety. After the speech is
over the person returns to a normal condition. Trait-Anxiety, on the other hand, refers to
a relatively stable tendency toward anxiety-proneness. A person with a relatively high
level of trait anxiety tend to perceive stressful situations as dangerous or threatening and
experience a heighten level of anxiety. The trait anxiety also suggests that there are
individual differences in the manner in which we react to stressful situations. Persons
with high levels of trait anxiety, tend to have high state anxiety more frequently,
especially in those situations that involve a threat to self-esteem. When it comes to
specific school anxieties, you are generally dealing with the elements of the state anxiety
because the reactions of the students are customarily temporary and disappear after the
threatening situation is over. State anxieties are also easier to control and tend to respond
fairly well to appropriate treatment, students can be taught how to handle taking tests.
Trait anxieties are more difficult to deal with because they involve a more stable element
of the personality and cause reactions in many more situations. This is not to say that
school personnel cannot deal with trait anxieties, it is simply more difficult.
One can also define anxiety by measuring the intensity of the physical reaction
(Lader, 1982; Greist, 1986). Physical indicators of anxiety are well known to all persons
and include some of the following: muscle tension, increased heart rate, sweating,
dizziness, frequent need to urinate, trembling, dryness of the mouth, queasiness in the
stomach, rapid breathing, and more. Because these are measurable physical reactions it is
possible quantify the intensity or change in these responses through a variety of
techniques, such as a polygraph. Studies involving general anxiety may include measures
of the physical response because they are reasonably objective. Most other elements are
anxiety are much more subjective because they rely on self-reported levels of anxiety by
the subject through paper and pencil inventories or questions such as, "Did you feel more
anxious?"
The last of our general definitions of anxiety actually comes from the test anxiety
literature, but is a useful general descriptor. Liebert and Morris (1967) introduced the
idea of breaking down the anxiety into components of Worry and Emotionality. The
Worry component refers to the cognitive elements of anxiety, the concerns about our
performance. Whereas the Emotionality factor pertains to the autonomic reactions. A
great many of the studies in the area of school anxieties reference these two elements.
In summary, the common thread in the general definitions of anxiety is that you
will find mental or cognitive elements as well as physical elements. So to restate, the
4
operational definition of a school anxiety is: a strong physical and psychological reaction
to specific situations in school that seriously impairs the ability of the student to perform.
There are different schools of thought on the relative importance of the physical
and psychological factors in the treatment of school anxieties (Hembree, 1988). Various
researchers and practitioners have debated whether the treatment should be primarily
behavioral to address the autonomic reactions, or cognitive to alter the psychological
factors. The debate can even get nasty at times, as seen in the following comments from
the "grandfather" of behavior therapy, Joseph Wolpe (1982):
"Recently, it has been proclaimed with an air of discovery, that cognitive errors
or distortions are, after all, the sole cause of neuroses.... Mahoney has labeled
this retrogressive viewpoint 'the cognitive revolution.' If neurotic problems are
all due to wrong ways of thinking, then thought correction must always be what is
needed to overcome them. While the cognitivists unflinchingly assert that this is
the case, it should be noted that in practice they frequently use behavioral
procedures such as assertiveness training and systematic desensitization, while
they minimize their import....I reject the view that the psychotherapeutic task is a
matter of nothing but cognitive correction, both because it is contrary to
established facts about autonomic responses, and because it is substantially
contradicted by clinical data..." (p.114-115)
For the purposes of this book, it doesn't really matter which treatment strategy is
more important because it is assumed that both cognitive and behavioral strategies are
necessary for all students. One factor may be more important, but the relative importance
will vary from student to student.
5
The Physiology of Anxiety
What actually happens within a person while they are experiencing anxiety?
Generally, that question is not really important to most school counselors because it is the
overt behavior of the student that is of concern. But knowledge of what is happening
within the body may provide some clues about the strategies that can be attempted. Now
the physiology of anxiety is a complicated subject that cannot be adequately explained in
simplistic terms. The body is so complex and anxiety reactions so pervasive that there
are a lot of unknowns. Given that caveat, the following is an explanation of what
happens during anxiety. In this particular section very little differentiation is made
between stress and anxiety. Anxiety is very stressful, however not all stressful situations
produce anxiety. Some researchers are looking at the nuances of difference between
various physical/emotional states, and this research is critical to new treatment strategies.
But looking at these particular differences is not particularly helpful here. So the
description used here is of a general aroused state, and how that may help or hinder
performance in school. One view of anxiety is that the aroused state does not produce the
anxiety, but it is the interpretation of that state by the person that causes the anxiety
(Lader, 1982).
One of the classic explanations of what happens to a person in an aroused state
comes from the work of Hans Selye (1974) on the reaction of humans to stress. Selye
used the biological principal that the body naturally tries to seek homeostasis, or an even
state. But certain demands and activities produce the need for the body to perform
numerous adaptive functions in order to re-establish normalcy. It doesn't matter whether
those demands are pleasant or unpleasant, we need to react. This reaction of the body to
stressors is described as the General Adaptive Syndrome (G.A.S.), which has three stages:
A.) Alarm Reaction.
B.) Stage of Resistance (learning to cope).
C.) Stage of Exhaustion.
On a physiological level it is the senses of the body that perceive a stressful stimulus and
the hypothalamus in the brain interprets these stimuli which in turn causes the pituitary
gland to secrete Adrenocorticotrophic Hormone (ACTH). The ACTH affects multiple
systems in the body, but primarily stimulates the adrenal glands to secrete corticoids.
And it is this secretion of the adrenal glands that has numerous effects on the body,
including a general arousal. The effects of the stressor will be felt long after the stressor
is gone. The ability of the body to react in this manner is critical for survival and a
certain level of stress is essential for healthy living, but continuous arousal can have a
detrimental consequence for a person and lead to various physical ailments.
The G.A.S. is helpful in explaining a little about the type of reaction that occurs
with school anxieties. A certain stimulus (such as a math test) triggers an alarm reaction
(A.) which triggers the stage of resistance (B.) where the student applies all available
positive or negative coping strategies to deal with this alarm reaction (studying hard,
6
avoidance, concentration during testing, etc.), and after the test just wants to go home and
take a nap (stage of exhaustion, C.).
The idea of an automatic sequence of reactions as suggested by the G.A.S. is a useful
introduction to the role of the Autonomic Nervous System with it's two main subsystems: The Sympathetic Nervous System (arousal) and Parasympatheic Nervous
System (calming). Most organs in the body have nerves from both the Sympathetic and
Parasympathetic systems. The effects of the two systems are general reciprocal,
however, certain organs can be stimulated by both. The best way to explain the systems
is the list the effects of both (Bloom and Lazerson, 1988; Fuerstein, Labbe and
Kuczmierczyk, 1986):
Sympathetic. This system is stimulated through the release of norepinephrine,
which acts as a neurotransmitter. Which means that it enables signals to be transmitted
from one nerve ending to another. The higher the concentration of norepinephrine, the
more the particular organs are stimulated. In general, this system organizes the body for
"fight or flight." Specifically the system has the ensuing effect on particular organs:
Pupils are dilated and the ciliary muscle relaxes to accommodate better distance vision.
The heart rate is accelerated and the intensity of muscle contractions is increased to raise blood
pressure.
Blood flow is shifted toward large muscles and the brain, with less going to the skin and digestive
tract.
Gastrointestinal motility and digestion are decreased.
The muscles around air passages relax, allowing more air to pass, the breathing rate increases
which in turn increases the percentage of oxygen in the muscles and brain.
The liver and fat cells are activated to release more glucose and fatty acids, the body's natural
fuels.
The Pancreas secretes less insulin, allowing the brain to use a higher percentage of glucose since it
does not require insulin to utilize the glucose.
The Adrenal glands secrete additional adrenalin (norepinephrine and epinephrine) into the blood
stream for more widespread effects.
Perspiration increases and when combined with the constriction of the blood vessels of the skin
produces a "cold sweat."
Some of the overall effects include increased oxygen to the heart, brain and muscles; increased
lactate (by-product of the metabolism of glucose in the muscles) in the heart and liver; increased
glucose to muscles heart and brain.
The overall factors are important because certain clinical studies (Mathew, 1982;
Pitts, 1982) suggest that increased levels of oxygen in the brain and lactate in the muscles
are associated with conditions present when persons are having anxiety reactions, and in
7
some cases the introduction of these elements were able to trigger anxiety reactions in
anxiety-prone patients. One can also see that the release of high levels of glucose could
result in a hypoglycemic (low blood sugar) reaction if the reserves of a person are poor
due to limited food intake.
Parasympatheic. This system sets the body up for rest and recuperation, using
acetylcholine as the neurotransmitter. The effects resemble the state of inactivity
following a large meal.
Pupils constrict and ciliary muscles contract to accommodate near vision (making it easier to read
a book).
Respiration is decreased and muscles contract to limit air flow.
Increased blood flow to the intestinal tract, and digestive processes are increased (necessary to
restore blood sugar levels).
Heart rate is reduced and blood pressure decreases.
Perspiration returns to normal function.
If one is intending to run a race or flee from a robber, sympathetic activation in
the body is very functional. However, if one is to pursue a relatively complex mental task
like take a test, an extreme reaction is not very helpful. It can be said that behavioral
efficiency is an inverted U-shaped function of arousal (Mathew, 1982), both high and low
levels of arousal being associated with behavioral inefficiency. In short, too little or too
much arousal will interfere with school performance.
Within the autonomic nervous system there are two main types of nerve receptors:
Alpha-adrenergic and Beta-adrenergic. The alpha-adrenergic receptors are associated
with those functions that are inhibited during sympathetic activation, while betaadrenergic receptors are associated with functions that are stimulated during sympathetic
activation. Or in other words, the beta-adrenergic nerves are the ones stimulated with the
release of adrenalin (epinephrine and norepinephrine). This is important to note because
some treatments for anxiety (Pitts, 1982) revolve around the use of drugs that are called,
"Beta-Blockers." In general, these drugs inhibit some of the physiological reactions
associated with arousal (rapid heart rate is the most evident), so a person receiving a betablocker will not have as strong of a sympathetic arousal and will not interpret bodily cues
as the onset of an anxiety reaction. Beta-blockers are also used in treatment of other
medical conditions related to sympathetic arousal, not just anxiety. There are numerous
other drugs that are used in the control of anxieties, but the probability of these being
used with normal school anxieties is quite remote. Drug therapy should only be used
under the careful supervision of an MD and is normally only applied for severe anxieties,
and school anxieties do not fit the classification of severe.
8
Other Physiological Considerations. There are some other physiological issues
that require comment relative to school anxieties. The first relates to work in the area of
blood flow in the brain. In the previous section on the autonomic nervous system, it was
mentioned that during sympathetic activation there is increased blood and blood sugar
flow to the brain. One would believe that this would help the anxious student perform.
Yet anyone who has been school anxious knows that a common reaction is, "my mind
went blank!" Why does this happen? One possible explanation comes from work on
where the blood goes in the brain.The difficulties involved in measuring this accurately
are substantial and studies are frequently contradictory. But in an attempt to summarize
numerous studies, Mathew, Weinman, and Claghorn (1982) came up with a tentative
hypothesis that you can differentiate between psychic (mental) and somatic (body)
anxiety. The psychic anxiety is associated with increased blood flow to the cerebral
cortex. While the increased sympathetic tone associated with somatic anxiety will result
in reduced blood flow to the cortex, with the blood going to central brain functions.
Which means that worry or mental anxiety alone should result in increased blood to the
portions of the brain associated with complex thinking. But if general body arousal is
involved, the blood in the brain will go to the centers that regulate physical reactivity, not
thinking. A potential conclusion from this is that heightened physical arousal will inhibit
the ability of a person to think straight.
A second special consideration is the work that has been done with
hyperventilation in patients with panic disorders (Wilson, 1986). In sympathetic arousal
the rate of breathing is increased because a higher proportion of oxygen is needed. If you
are jogging, your body needs this increased oxygen and the appropriate level of carbon
dioxide is produced as a by-product of metabolism in the cells and expelled via the lungs.
But if you are sedentary and you breathe at this same rapid level you will start to
hyperventilate, meaning there is a higher proportion of oxygen and not enough carbon
dioxide. The balance between the two is necessary to have the correct level of
metabolism, too much oxygen will mean a higher level of activity in the muscles
(arousal). Over time, the hyperventilation becomes a trigger to start a panic attack
because the person will feel like he or she is going to faint, or will have trouble breathing.
Patients are taught how to do lower chest breathing (diaphragm) which tends to keep the
carbon dioxide in balance, rather than engaging in rapid upper chest breathing that tends
to increase oxygen. The lower chest breathing becomes a trigger for parasympathetic
stimulation and inhibits the panic attack.
The third area relates to the discovery of certain elements in the central nervous
system that have natural calming effects, and are called endogenous opiates. These
include endorphins which appear to be produced following stressful events, and Gammaaminobutyric acid (GABA) which is a neurotransmitter. The format of this book does not
lend itself to a full discussion of these substances, nor do the biochemical skills of this
author permit a full understanding. But suffice to say, this is likely to be and area of
fruitful future research that may generate new ways to influence inappropriate emotional
and physical reactions (Molinaro, 1986; Enna, 1982).
9
In summary, the physiology of anxiety is that of a heightened state of physical
arousal stimulated by the elements of the sympathetic division of the autonomic nervous
system. How one interprets that physical state determines whether it is anxiety or simply
an appropriate state of arousal.
The Cognitive Elements of Anxiety
The physical elements of anxiety are hard to explain due to the complexity of the
human body, the cognitive elements are hard to explain, but for a different reason: you
cannot really measure cognitions. To understand cognitive processes one must attempt to
create psychological constructs that lend themselves to indirect measurement. There is
greater disagreement in this area then in the physical. The range include persons such as
Wolpe (1969, 1982) who appear to care very little for the cognitive elements, to Ellis
(1975, 1977) who places almost exclusive emphasis on the cognitive. The purpose of this
section is to explain the basic schools of thought of those researchers who believe that
cognitive factors influence anxiety. From this author's perspective there are three main
perspectives: Skills Deficit, Cognitive Processing Deficit or Faulty Thinking, and the
Misinterpretation of Data. In reality all three of these perspectives generally accept the
views of the others, so they should be considered complementary, rather than totally
unique. In later chapters suggesting treatment approaches, the cognitive view will be
explained again.
Skills Deficit. This particular explanation suggests that the anxiety is a result of
the person lacking the skills to satisfactorily perform the desired behavior. It is reality
based. For example, a person with limited experience or training in public speaking
realistically should be nervous if asked to speak to a large gathering. After some
instruction and practice in speaking skills the anxiety should be reduced. The skills
deficit approach is by far the most common strategy used by schools to conquer things
such as test, math or speech anxiety. It is a rare school that doesn't offer classes in how to
study or worshops on test taking, time management and a myriad of study skills. Basic
classroom instruction is skill development to enable students to master new material and
perform in new situations. For the vast majority of students this is all that is needed.
Another way is labeling this is to call them Academic Coping Skills (Ottens, 1984) and
work with the student to identify the skill deficiencies and develop a repertoire of coping
skills to apply to particular situations.
The skill deficiency model is also used in general anxiety reduction through things
such as: assertiveness training, teaching people how to use things like public
transportation, teaching cue-related relaxation, practicing verbal social interactions, etc.
In general, the skill deficiency approach assumes that the person is reponsible for his or
her own behavior and can learn new ways to function that will lead to success.
Cognitive Processing Deficit or Faulty Thinking. The cognitive processing deficit
approach suggests that our thought processes get in the way and produce the unwanted
10
feelings or behavior. For example, if I believe that I am a crummy student and never do
well on tests, I probably won't do well. The most well know proponent of the cognitive
processing approach is, of course, Albert Ellis. His Rational Emotive Therapy (RET)
presumes that it is irrational thinking that sets off a chain of mental reactions that in turn
produces the unwanted behavior. By becoming aware of our faulty thinking, challenging
these illogical thoughts and replacing them with more logical thought, we can change
how we think and act. Ellis' prolific writing and active professional life has helped to
make this a well-known and often practiced approach. Literally thousands for persons
have adopted many of his approaches and have built variations off this basic theme. Next
to the skills deficit approach and systematic desensitization, this is probably the most
popular approach taken with students who have school performance problems.
Misinterpretation of Stimuli. We view the world through our own "filters." Our
senses input information, but our brain provides the interpretation and attaches meaning.
Sometimes the meanings we attach are inappropriate and can create problems. By a more
correct perception of reality we can prevent the problems from happening. Aaron Beck
(1985) cites an example of a man who while skiing began to have shortness of breath and
felt faint (not uncommon at high altitudes). He turned that into a full blown panic attack
through the belief that he was having a heart attack and could never get to the hospital in
time. As related to school situations, a student may perceive that a particular teacher is
deliberately trying to make it hard for him, when in fact the teacher is trying to challenge
the student. The basic treatment strategy is to make the student more aware of his
cognitive processes and the images that he is creating in his mind, then supply correct
information so that an improved perception can be made. This could be as simple as
explaining the reality of the situation to a person. Or as complex as having the person do
extensive reading, data gathering, and
practice.
Summary
In this chapter school anxiety has been defined as a strong physical and
psychological reaction to a specific situation that interferes with the ability of a student to
perform in school. The physical condition is one of arousal as stimulated by the
sympathetic portion of the autonmous nervous system, and this arousal is
counterproductive to clear thinking. Some of the mental reactions include self-doubts or
interfering thoughts, as well as lacking some of the necessary academic skills.
Selected References:
Beck, A. T.; Emery, G. Anxiety Disorders and Phobias: A Cognitive Perspective. Basic
Books: New York, 1985.
Bloom, F. E.; Lazerson, A. Brain, Mind and Behavior. W.H. Freeman and Company:
New York, 1988.
11
Ellis, A.; Grieger, R. Handbook of Rational-Emotive Therapy. Springer: New York,
1977.
Ellis, A.; Harper, R. A New Guide to Rational Living. Prentice-Hall: Englewood Cliffs,
New Jersey, 1975.
Enna, S.J. The Role of Neurotransmitters in the Pharmachologic Actions of
Benzopiazepines. from: The Biology of Anxiety. Roy J. Mathew (ed),
Brunner/Mazel: New York, 1982. p.107-119.
Feuerstein, M.; Labbe, E; and Kuczmierczyk, A. Health Psychology: A Psychobiological
Perspective. Plenum Press: New York, 1986.
Greist, J. H.; Jefferson, J. W.; Marks, I. M. Anxiety and Its Treatment. American
Psychiatric Press: Washington, D.C., 1986.
Hembree, R. Correlates, Causes, Effects and Treatment of Test Anxiety. Review of
Educational Research, 58(1), Spring 1988, p. 47-77.
Lader, M. Biological Differentiation of Anxiety, Arousal, and Stress. from: The Biology
of Anxiety, Roy J. Mathew (ed.). Brunner/Mazel: New York, 1982, p.11-22.
Mathew, R. J.; Weinman, M. L.; Claghorn, J. L. Anxiety and Cerebral Blood Flow. from:
The Biology of Anxiety, Roy J. Mathew (ed.), Brunner/Mazel: New York, 1982,
p.23-31.
Molinaro, J. A. The Relationship of Test Anxiety to Serum Beta-endorphin. EDRS #276564, 1986.
Ottens, A J. Coping with Academic Anxiety. Rosen Publishing Group: New York, 1984.
Pitts, F. N.; Allen, R. E. Beta-Adrenergic Blockade in the Treatment of Anxiety. from:
The Biology of Anxiety, Roy J. Mathew (ed.), Brunner/Mazel: New York, 1982,
p.134-158.
Richmond, V. P.; McCroskey, J. Communication: Apprehension, Avoidance, and
Effectiveness. Gorsuch Scarisbrick: Scottsdale, Arizona, 1989.
Selye, H. Stress Without Distress. J.B. Lippencott: Philadelphia, 1974.
Spielberger, C. D. Test Anxiety Inventory: Preliminary Professional Manual. Consulting
Psychyologists Press: Palo Alto, 1980.
Spielberger, C. D. Manual for the State-Trait Anxiety Inventory. Consulting
Psychologists Press: Palo Alto, 1983.
Wilson, R. R. Don't Panic: Taking Control of Anxiety Attacks. Harper and Row: New
York, 1986.
Wolpe, J. The Practice of Behavior Therapy, Third Edition. Pergamon: New York,
1982.
Wolpe, J. Our Useless Fears. Houghton Mifflin Company: New York, 1981.
Wolpe, J. The Practice of Behavior Therapy. Pergamon Press: New York, 1969.
CHAPTER TWO
12
ASSESSMENT OF SCHOOL ANXIETY
This is the first of several chapters that are designed to be practical guides for
counselors and teachers who are working with school anxious students. This one deals
with the area of the assessment of school anxiety. In many ways it is appropriate to ask,
"Why do I really care about assessing this? If the student says he or she gets nervous, I
believe it, and we go on from there." That is true, generally a very formal assessment is
not necessary since in school setting one is usually dealing with very functional
individuals who provide reliable self-reports of their own experiences. And it is these
student self-reports that are the backbone of nearly all anxiety assessment in schools. Ask
the person what they are experiencing and they will tell you! The interpretation of what
is said by the counselor or teacher becomes the assessment. Whether the assessment is
formal or informal depends on the needs of the situation.
Types of Assessments
There appear to be three main types and purposes of assessment: a.) Clinical
Assessment. Although the word "clinical" may seem too medical for some school people,
this type of assessment means gathering information to determine the type of treatment to
apply. Or in other words, "How are we going to help this person?" This is by far the
most commonly applied assessment, and in many cases counselors and teachers do this
almost unconsciously. The most frequent medium is to interview the student and ask
appropriate and probing questions. In some cases psychometric devices may be used in
conjunction with an interview. b.) Evaluation of Treatment. We often need to know
whether or not what we are doing is effective. This too may be as informal as asking the
student, "How has this helped you?", or could involve a more formal research/evaluation
design. c.) Research Questions. It is important that we carefully study the various
psychological and behavioral constructs related to school anxiety. Research designs
generally contain more carefully constructed assessment tools so that results can be
compared to other studies and confounding variables eliminated.
Persons working with students on a daily basis in school rarely have the
opportunity or resources to conduct research. However, they can benefit from the results
of the investigations. Many of the tests being used to identify the types and intensity of
school anxiety have come from studies trying to analyze the various psychological
constructs. And an awareness of what is available can be an invaluable asset to a
counselor or teacher. In this chapter several different tools are suggested, however, it is
certainly not a comprehensive list. Scores of different assessment are available, many
with very specific purposes that could fit into your needs. Do not limit yourself to the
tools suggested here.
13
Sample Clinical Screening Interview
As mentioned in the introduction, one of the primary assessment devices is the
clinical interview, simply asking the student some questions to determine a treatment
plan. The following is an example of the interview strategy used by this author with
students at a community college. The sample is for students who are having difficulty
with test anxiety, but could easily be adapted to other forms of school anxieties.
The primary purpose of the interview is to determine if the student needs to get
involved in a group or individual experience involving systematic desensitization, or
whether there are things the student can do without continual intervention. So the
interview generally progresses on a priority basis with those items under the control of the
student attempted first. Meaning, that if the student is simply not spending adequate time
studying, he or she will first be asked to study more (and keep track of the time), before
automatically placing him or her in a systematic desensitization group. Another
underlying assumption is that usually there are multiple causes of a student's test anxiety,
and it is this combination of factors that needs to be addressed. The goal of the interview
is to uncover these factors, bring them to the awareness of the student and the counselor,
and mutually develop a plan to deal with them.
INTERVIEW CONTENT
A.) Behavioral Description.
The student first needs to describe in detail what happens when she or he takes a
test. They need to identify how their body felt and what was going through their mind.
The tendency is to place blame on external sources, such as the teacher. For change, it is
essential that they have an understanding of their reactions. It is helpful for the student to
focus on a particular test or incident.
Typical questions:
Tell me what happened during your last test?
14
What did your body feel like? (They usually say, "Nervous." What does nervous
feel like to you?)
Did you feel like you were going to get sick to your stomach?
Has this ever happened before and does it happen in situations other than testing?
When do you first recall it happening?
What was going through your mind, what were you saying to yourself?
How did you feel when the test was over? Did you think you had passed?
On occasion a student will have some difficulty recalling the events of a particular test
and describing them in behavioral terms. If the student really gets blocked have him or
her get very relaxed and then you provide a mental image of a particular testing situation.
Immediately afterward, write down what the student felt and thought during the mental
imagery.
B.) Study Routine.
(See the Chapter on Study Skills for more detail.)
Frequently students do not know how to study effectively or simply do not devote
adequate time to it. The objective of the interview at this point is to gather detailed
descriptions of what the student is doing to prepare for tests and complete assignments.
One common response by students is to say, "I read my textbook." Try to get past this
statement into how the student is reading and whether he or she is using active reading
techniques, such as outlining or writing down questions.
Typical Questions:
Describe in detail what you do to get ready for a test.
When you say you read your textbook, how do you read?
Do you ever use tutors or study with others?
How much time do you spend per day (week) studying?
Where and when do you study?
Do you find that your mind wanders while you study? What do you do when that
happens?
15
As you are studying, are you aware of any self-talk or things you are saying to
yourself?
Possible treatments if this is a problem area:
Referral to a study skills class.
Tutoring or individual instruction on how to study.
Referral to a reading skills class.
Encourage the use of a study group or study buddy.
Request that the student spend more time studying, and that he keep a time log.
Directly teach the student study strategies you have used effectively.
C.) Test Taking.
(See the Chapter on Study Skills for more detail.)
Frequently students lack experience in taking complex tests, or in the type of test he or
she may encounter in a college setting that requires considerable independent thinking. In
the case of returning adults, it may have been a considerable length of time since a test
was taken. The goal of the interview is to determine if the student has a effective testtaking approach, or are certain behaviors getting in the way.
Typical Questions.
Describe the process or strategies that you use when you take a test.
Are there particular things you do with multiple choice tests? Essay Tests?
Do you skip questions?
What to you do when your mind goes blank?
What do you do just prior to the start of a test?
Possible treatments if this is a problem area.
Referral to a study skills class or test taking workshop.
Tutoring in test taking skills.
Have the student complete lots of practice tests.
Have the student create the tests him or herself by using chapter reviews or
writing questions directly from the text.
Provide individual assistance on test taking strategies that you have used.
16
Encourage the student to adopt a deliberate test taking strategy such as skipping
questions that don't result in immediate recall.
Teach the student a quick relaxation method (deep breathing, cue-controlled,
images, etc.) that can be used just prior to or during a test.
D.) Lifestyle Considerations.
(See the Chapter on Stress Management for more detail.)
Problems in diet, general health, and living situation can negatively impact school
performance. School anxious students in particular seem to be more sensitive to dietary
problems and stressors at home. These students may not have any more stress or dietary
problems that other students, it is just that their predisposition to test taking problems
makes them more vulnerable to other factors. The goal of this stage of the interview is to
try to unearth any problems that can be changed or modified. In some cases one
discovers some problems that cannot easily be controlled by the student. For example,
maybe the student's spouse just died or has a severe illness. Treatment will simply be
time and support, not a quick remedy.
Typical Questions.
Describe what and when you have eaten in the last 48 hours. Is that typical?
How much sleep do you normally get and what is the nature of your exercise
routine?
Have there been any major changes occurring in your life recently?
Describe these.
Describe your living situation. Who is there, what kind of pressures or support
do they provide, is there encouragement and understanding about your
going to school?
Do you have any physical conditions that could possibly impact your school
performance? Are you taking any medications for this condition?
Possible treatments if this is a problem area.
Get the student to eat regular meals throughout the day, especially breakfast. A
balanced diet from all food groups is essential, emphasizing: proteins, fresh fruits
and vegetables, and whole grain foods. Decrease things such as: caffeine, sugar,
salt, and alcohol.
Discuss the components of a healthy lifestyle, including how to get involved in
regular aerobic exercise.
17
If there are major changes occurring in the student's life (death in family, divorce),
suggest regular counseling to assist in adjustment.
Discuss how to renegotiate responsibilities within the family. For example, Mom
is now in school, things aren't the same as they used to be, how can we change?
Gather information from a physician providing treatment for the student, ask for
any possible side effects from medication.
Refer the student for a physical.
Teach the student some techniques about how to put regular relaxation into their
lifestyle: deep muscle relaxation, deep breathing, fantasy, taking walks,
meditation, hot baths, etc.
E.) Referral for More Treatment.
(See the Chapters on Systematic Desensitization and Specific School
Anxieties for more detail.)
If it appears that the student is studying relatively well and has lifestyle issues in
reasonable control, yet is still getting strong physical and emotional reactions in testing
situations, then he or she probably should get involved in either a test anxiety group or
individual counseling. The treatment would probably involve systematic desensitization
and/or cognitive therapies. In some cases you may wish to start the student right away in
the treatment group, even if there are also study and lifestyle issues that also need to be
controlled.
In summary, the sample clinical interview is a way to get at the sources of anxiety
for the particular student. Given the time and logistical limitations of student and
educators in schools, it is not possible to place all students who hint at anxiety problems
into a class or individual counseling. An interview like the above is designed to uncover
potential activities that the student can pursue without direct professional intervention.
This also gives the student a sense of empowerment and responsibility over the anxiety.
That in itself is a potent treatment method.
Standardized Anxiety Assessments
There may be cases or situations where it is preferred or necessary to utilized one
of the many standardized assessment devices to measure a particular school anxiety. This
is particularly true when it is necessary to conduct a formal evaluation of the success of
treatment or if trying to analyze the presence of a particular psychological construct.
18
Some professionals will use standardized assessments for a particular time early in their
work with school anxious students in order to gauge their own assessments of school
anxiety, then gradually phase out the use when they have sufficient experience. The
following are descriptions of commonly used assessments that one will frequently find in
the literature. They are copywritten materials that must be ordered directly from the
publishers. It is not an exhaustive list, there are a great many other resources can can be
used. It is merely a sampling of instruments that are relatively inexpensive and easy to
use. Individual users are encouraged to review other instruments as well.
General Anxiety. The "classic" measure of anxiety that has been cited for years is the
"Manifest Anxiety Scale" developed by Janet Spence (1953) by extracting items from the
MMPI. It served as a stimulus for a great many studies and other assessments because it
relied on self-reports of behavior and was easily interpreted. Although, not a direct
product of the Manifest Anxiety Scale, the work of Charles Spielberger in assessing State
and Trait Anxiety does bear some resemblance to this earlier scale. The State-Trait
Anxiety Inventory (Spielberger, 1983. Available from: Consulting Psychologist Press,
Inc. 577 College Ave., Palo Alto, CA 94306) consists of 40 brief statements such as, "I
feel calm. I am jittery. I feel satisfied with myself." The person completing the
evaluation marks whether the statements apply to him, "Almost Never, Sometimes,
Often, Almost Always." Twenty of the questions pertain to "State Anxiety, which is the
temporary or transitory condition of feeling anxious. Twenty pertain to "Trait Anxiety,"
which is the more stable or personality tendencies for anxiety-proneness. The manual
contains a good discussion of these constructs with abundant references and a variety of
norms.
Test Anxiety. Because of the pervasive nature of test anxiety there are many potential
measures. The one preferred by this author is the Test Anxiety Inventory. by Spielberger
(1980, available from: Consulting Psychologist Press, Inc. 577 College Ave., Palo Alto,
CA 94306) because it attempts to measure both physical and cognitive factors of test
anxiety. It measures the constructs of Worry (cognitive factors) and Emotionality
(physical response). It is a quick screening device because it only asks twenty questions
and you get a Total score and sub-scores for Worry and Emotionality. Brief statements
are provided, "I feel confident and relaxed while taking tests. During tests I feel very
tense." and the person is asked to respond by saying the particular statement describes
how they feel, "Almost Never, Sometimes, Often, Almost Always." The manual is
relatively brief, but contains more than adequate information for users. Norms are
provided for several different groups and it would re relatively easy for a person to
develop a table of local norms if needed.
Math Anxiety. One of the most commonly cited measures of mathematics anxiety is the
Mathematics Anxiety Rating Scale. (MARS) by Suinn (1972, available from: Rocky
Mountain Behavioral Science Institute, Inc. P.O. Box 1066, Fort Collins, CO 80522).
The MARS consists of 98 statements revolving around mathematical situations or
experiences that a person may have. The person then rates whether the particular
situation makes him or her feel anxious, "Not at all, A Little, A Fair Amount, Much, Very
19
Much." It is hand scored very quickly and derives a total score. In addition to the total
score the author states that it is a useful tool in the construction of hierarchies for
desensitization because it will yield a variety situations at different levels. It can also be
repeated to measure progress in therapy.
Communication Anxiety. A quick screening device is the Personal Report of
Communication Apprehension (PRCA-24). by McCroskey (1982, found in
Communication: Apprehension, Avoidance, and Effectiveness. by Richmond V.P. and
McCroskey, J.C., Gorsuch Scarisbrick Publishers: Scottsdale, AZ, 1989). The PRCA-24
presents 24 statements from communication situations, "I dislike participating in group
discussions. I am afraid to express myself at meetings." and the respondent has to rate
whether he or she will "Strongly Agree, Agree, Are Undecided, Disagree, Strongly
Disagree." with how the statements apply. It yields a total score and subscores relating to:
Group Discussions, Meetings, Interpersonal conversations, and Public Speaking. In
addition to the above scale, McCroskey also gives copies of several other scales relating
to particular communication anxieties: Shyness Scale, Willingness to Communicate
Scale, Writing Apprehension Test, Test of Singing Apprehension, Personal Report of
Public Speaking Anxiety, and Communication Apprehension in Generalized Contexts.
These scales could be used for research purposes, screening, or for the construction of
hierarchies. Detailed norms are not provided.
Science Anxiety. As part of Loyola University of Chicago's Science Anxiety Clinic
students were asked to complete the Science Anxiety Questionnaire. (found in: Science
Anxiety: Fear of Science and How to Overcome It. by Mallow, Jeffry. Thomond Press:
New York, 1981). Students complete a 44 question survey of science related situations
and asked to rate how frightened by are by the situations, "Not at all, A little, A fair
amount, Much, Very much." Norms are not provided, but it can be a useful tool for a
screening interview, or in the development of hierarchies. Local norms could be
developed.
Selected References.
Mallow, J. V. Science Anxiety: Fear of Science and How to Overcome It. Thomond
Press: New York, 1981.
Ottens, A. J.; Tucker, K. R.; Robbins, S. B. The Construction of an Academic Anxiety
Coping Scale. Journal of College Student Personnel. 1989, 30, 249-256.
Richmond, V.P.; McCroskey, J. C. Communication: Apprehension, Avoidance, and
Effectiveness. Gorsuch Scarisbrick Publishers: Scottsdale, AZ, 1989.
Spielberger, C. D. Test Anxiety Inventory: Preliminary Professional Manual. Consulting
Psychyologists Press: Palo Alto, 1980.
Spielberger, C. D. Manual for the State-Trait Anxiety Inventory. Consulting
Psychologists Press: Palo Alto, 1983.
20
Taylor, J. A. A Personality Scale of Manifest Anxiety. The Journal of Abnormal and
Social Psychology. 1953, 48(2), 285-290.
21
CHAPTER THREE
STUDY SKILLS CRITICAL TO SCHOOL ANXIETY
Study skills are the first of the "cognitive therapies" for the control of various
school anxieties and are designed to improve the ability of students to master the content
of their classes. Without first learning the material, no amount of relaxation training or
other treatment will significantly improve student performance. The single most effective
treatment of school anxieties is to first teach our students to be expert and dedicated
learners.
Persons who are experts in study skills can skip this chapter after reading the first
couple pages. There is nothing presented here that is new or innovative, simply some
basic suggestions for skills to teach your students. Someone seeking more detailed
instruction in the area of study skills should use some of the excellent references or
student textbooks available (Ellis, 1985; Hoehn & Sayer, 1989; Devine & Meagher,
1989).
Four Problem Areas
There are, however, certain problems in particular that plague students with
school anxieties, especially test and math anxious students. And it is these specific
problems that will be used as examples. The following are some of the special study
problems that this author has found in school anxious students:
1.) Problems in Managing and Controlling Time. These students tend to feel that
time is controlling them and they can do little about it. They tend to under commit time
to school work and waste a lot of time. They feel "under the gun."
2.) Problems in Concentrating and Remembering. Because of the pressures and
anxiety, they may not remember what they have read and find they forget things under
pressure.
3.) Difficulties in Managing the Test or Evaluation Situations. This includes
making a lot of "stupid" mistakes on tests, running out of time, changing correct answers.
It may stem from a lack of experience in taking tests.
22
4.) Lack of Assertiveness and Accepting Responsibility. The tendency is to blame
other persons for their lack of performance and not take charge of their own academic
performance. They tend to let things happen "to them."
By dedicating time to learning some general study skills and by concentrating on
the above areas, most school anxious students can reduce the level of their anxiety and
significantly improve performance.
Time Management
One particular problem is that students may not be spending adequate time
devoted to study. In a recent survey of community college students about their study and
test taking habits this author asked that students estimate the number of hours per week
that they dedicate to study. On the average, the students spent less than one hour per
week for each credit hour they were taking! This is well below the "two hours per credit
hour" standard that many educators recommend. And even if this limited amount of time
is very effective study (which it probably isn't), it is not enough time to get the job done.
A typical student reaction is "I don't have enough time to get it all done." In some
cases this is a true statement, they are over committed. Let me cite the example of
Lauren:
Lauren was a good student who for the first time in her life found herself
in a situation where she was not coping very well with school. She was feeling
sick often and occasionally panicked when a new assignment was given by her
instructor. Her grades were starting to go down and her confidence in herself was
waning. Lauren's husband was a marketing representative for a pharmaceutical
company and had to travel regularly, leaving the responsibility of home and
children (two girls, aged 7 and 9) to Lauren. In addition to taking 9 credits she
volunteered time at the children's school, was a girl scout leader and served on a
church committee. After keeping track of her time for about a week she
discovered she was only spending about 5 hours per week in quality study time,
and maybe another 5 hours in "high interference" study. She thought she had
adequate time to study, but after analyzing it, she had to make some changes. The
following is what was done:
She reduced her volunteer hours at school so she could have additional study time
while the girls were in school and she would have no interference. She
discontinued the church committee. She and her husband re-negotiated some
home management responsibilities. He was not aware of the time pressures that
she was encountering. She arranged to have the girls spend a few hours per week
at a neighbor's house with some friends. During school vacation times and
between terms she would take the neighbor girls so the neighbors could take trips.
23
She instituted a "family study hour" after dinner. Everyone had to be studying or
reading. If they completed the study hour they could have a special treat or watch
a favorite TV program. She found that the girls would help more with the dishes
because the study hour wouldn't begin until the dishes were done. The longer it
took to clean up, the less chance they had to watch TV.
The fundamental step involved in Lauren bringing things into control was the fact
that she completed a time log. She wouldn't have recognized her lack of adequate quality
study time if she hadn't completed a time log. One of the best ways to complete a log is
to first make an estimate of the actual schedule, then keep track of what actually
happened. For example, one day of Lauren's schedule:
Day: Monday
Time
Plan
Actual
6-7 am
Wake-up, Dressing
Same
7-8 am
Breakfast, get everyone
ready to go.
Clean house, misc.
Same
Just got ready for school
10-11am
Study til 10:30, then
get ready for school.
Get to school.
11-12noon
Psych. class
Same
12-1pm
Lunch and study
with friends
English class
Studied in student center,
8-9 am
9-10 am
1-2pm
2-3pm
Cleaning took until 10
Same
3-4pm
Quick study, then to
No study had to get ready
girls school for Scouts for scout meeting.
Girl Scouts
Same
4-5pm
Get dinner ready
Same
5-6pm
Have dinner, dishes
Dinner, et.al lasted until 6:30
6-7pm
Relax
Talked on the phone.
7-8pm
Study
Same
8-9pm
Get girls to bed and
Same
24
9-10pm
ready for next day
Study
Didn't get started until 9:30
10-11pm
Relax, get ready for bed
Didn't get to bed until 11:30
It was by analyzing this schedule over several days that Lauren began to develop some
strategies for coping. A wide variety of similar schemes can be developed depending on
the person, but the key is to get a handle on what is actually happening, rather than what
the person believes is happening. With adequate information, then appropriate changes
can be made.
Another area of concern arises from the fact that many of these students do not
develop a careful plan about how to study and what needs to be done. Frequently
students will try to remember all of the assignments and due dates in their head, or will
only have marginal notes about their plans. School anxious students are more sensitive to
"worry" problems and not having adequate plans compounds their difficulties. One way
to counteract this is to have them construct a study calendar. Obviously there are many
ways to accomplish this and each student should develop his or her own method of
scheduling. The following is what this author prefers to teach his students:
1. Have students obtain a large monthly calendar with plenty of space to write in
assignments for each day. This is preferred over a pocket daily calendar because a
person can easily scan several days or even weeks ahead. School anxious students
tend a worry a lot and have difficulty tolerating surprises. By being able to glance
ahead they are less likely to be shocked to realized that they had completely
forgotten an assignment or test. Or when adjustments have to be made in study
plans due to personal issues, it is easy to see how to move things around.
2. When an assignment is given or test announced the student should write that
on the calendar, then work backward to the present date with study steps leading
up to that assignment. For example, an English paper is due on the 20th of the
month and the current date is the 5th. On the 18th it should say: Complete the
final draft. On the 16th it should say: Edit the first draft. On the 13th it should
say: Enter the first draft on the word processor, etc. Other significant life events
should also be written on the calendar so the student can work around these
events. Some students may also wish to write more detailed daily calendars or "to
do" lists , but for many students simply mapping it out in a general manner is
sufficient. The following is a sample a two week section of a simple study
calendar:
Sample Study Calendar
SUNDAY
MONDAY
TUESDAY
WED.
25
THURS.
FRIDAY
SAT.
(Week one)
Write ideas
for topic in
English
Read
History
Library:
Research on
Eng. Paper
Read
Chapt.4
Review 4
Review
class notes
Math Probs.
Chapt 5, 6
(Week 2)
Outline
paper
Write first
draft.
Review
class notes.
Study with
friends
Math probs.
Chapt. 7.8
More
Library
research
Math Probs.
Chapt. 5, 6
Review
homework
5,6,7,8,
Read
Chapter 6
Sample test
Chapt 4, 5,
6
Edit and
start typing
History test
Chapt 4,5,6
Sample
Questions
Chapt 4,5
English
paper due.
Read
Chapter 7
Math
sample test:
7,8
Math test
5,6,7,8
There are a number of things that a study calendar of this sort accomplishes. First
of all it forces a student to set study goals for the day, there is a general plan of what must
be completed that day. It can be very rewarding to check items off the calendar or daily
plan as they are completed. Students can be encouraged to reward themselves in some
manner when they achieve a goal. Another subtle, yet very significant benefit, is that it
enables the student to focus on the present. Students who do not fully write down future
assignments constantly worry about all that has to be done. A student with a schedule
only needs to worry about today, and for a school anxious student this is essential. When
the study goals for the day are satisfied, the student can go to bed or to another activity
with a clear mind and conscience. Dave Ellis in the Master Student course (Ellis, 1985)
drives home this point with the phrase, "Be Here Now." This concept is interwoven
throughout the workbook as a way to encourage students to be fully involved in the
present. All too often we are worrying about the future or the past and miss something
that is happening now. Forcing the present focus enables a student to more attentive in
class and while studying and can therefore study more efficiently.
Concentrating and Remembering
How many times has a student reported to you, "I studied for hours last night and I
can't remember anything I studied!" Or, "When I got to the bottom of the paragraph I
26
realized that I wasn't concentrating and couldn't remember what I had read." All of us as
teachers and students have shared these experiences and recall that they happened when
we were either tired or had our minds on something else. Students who are school
anxious have an even harder time with this because the physiological impact of anxiety
arousal does make it hard to think clearly and remember. Therefore school anxious
students must do a better job of concentrating and remembering than the typical student,
because the probability of them having physiological interference is far greater. The
following are some of the strategies (from many thousands that are taught) that seem to
help school anxious students:
1. Don't Study When Highly Anxious. When in the midst of anxiety reaction or
when under a great deal of stress it is nearly impossible to concentrate or use
higher level thinking skills. Yet students will respond, "Yes, I get anxious while I
study because I worry about all the work I have to do. If I didn't study, then I
would get even more anxious." It is a vicious cycle, but students should be
instructed not to study at these times. Suggestions could include taking a break
and engaging in activities that will reduce the physiological effects of the anxiety:
deep muscle relaxation, meditation or prayer, vigorous physical activity, talking
on the phone with a friend, etc. Once the physiological effects of the anxiety are
reduced, then return to the studies. From a behavioral point of view you don't
want to be pairing study with muscle tension, instead you want to be pairing it
with relaxation and a positive attitude.
2. Utilize the Science of Learning Theory. Two simple concepts from learning
theory can be taught to students: Distributive Practice and Overlearning.
Distributive practice means instructing students to spread out their study time over
several days in order to give the concepts and facts time to move from short term
memory to long term memory. Having short, concentrated study times on regular
basis is better than cramming the night before a test. Some students can tolerate
cramming more than others, but with the school anxious student it just heightens
the anxiety. Overlearning is related to distributive practice because it suggests
that many repetitions of a behavior make it more difficult to extinguish--the
greater the number of times you repeat a review of subject matter, the greater the
chance for remembering it.
3. Use Multiple Senses in Study. While doing the distributive practice the student
should be instructed to not simply sit passively and read notes. Using as many
senses as possible will help. The student must literally touch it, feel it, smell it,
and taste it. This includes: Reading notes aloud, listening to it being spoken,
writing and recopying ideas, drawing pictures of concepts, building models,
discussing ideas with a "study buddy" or study group. One fairly simple technique
is to write down critical ideas or terms on 3x5 cards, even drawing pictures on the
cards if possible. These can be read aloud and reviewed regularly. Concepts can
be recorded on a cassette and listened to while riding in the car.
27
4. Recognize Good and Bad Study Times. Students can begin to track their own
"biorhythms" to determine when they are at their best, then plan to the work that
requires the greatest concentration at times when they are at their best. For
example, if a student finds that she is most alert just after breakfast, then that
should be the time to read her most difficult material. If mid-afternoon is a time
when it is hard to be alert, then that is the time to do laundry, cut the grass or do a
workout. Students can also divide work into "think work" and "non-think work."
Non-think work could include things such as review of class notes, going through
flash cards, making charts for a presentation, etc. The non-think work can be
reserved for times when there is a lot of interference, like studying in the student
center or while waiting for the bus. Some students will even try to involve other
members of the family, like the man who would have his seven year old daughter
quiz him from flash cards while he would make dinner. The work requiring
concentration is saved for times when the student can work in a quiet location and
is alert. The school anxious student is distracted easily and needs all the
advantages possible.
5. Study Less Material. Students often attempt to learn everything that is in the
textbook or presented in class lecture. A helpful strategy, especially in classes
that involve a large amount of material, is to have the student prepare abstracts of
study material. Combine reading and lecture notes into a single summary. Five
pages of preliminary notes easily condense into a one-page summary of the critical
information. In addition to having a study summary, the student has engaged in
the active study process of compiling the information.
6. Utilize Active Reading Techniques. Most colleges and university have semester
long classes teaching students to read more effectively, and it is rather
presumptuous to provide brief suggestions here. But one portion of the reading
dilemma faced by school anxious students is the sometimes inexplicable tendency
to not be able to concentrate while reading. Extraneous thoughts keep running
through their heads. While studying Algebra, they worry about their English
paper. Can this be solved? Not very easily. But one way is to counteract passive
study techniques with active study. When asked how they study, students
frequently respond in a manner that suggests that the study approach taken does
not involve a lot of interaction with the material. Consider the following dialog:
Counselor: Tell me what you do to get ready for a Psychology test.
Student: Well, I read my textbook.
Counselor: What do you mean by, "read your textbook?"
Student: (with a quizzical look on his face). I read it. I put the book on
my lap, prop up my feet,and begin to read.
Counselor: That's all?
Student: Yes, what else would you do?
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Within a couple of minutes, the above student will probably be thinking about
something else or minimally alert unless the material is exceptionally exciting.
Active reading techniques require that the student do something else with the
material in addition to simply reading it. These include:
Pre-reading or scanning it in advance.
Outlining on separate paper while reading.
Making flashcards of vocabulary or key terms while reading.
Writing sample test questions on cards.
Stopping periodically to discuss it with a study partner.
Rephrasing material in your own words, either on paper or to a tape recorder
for playback.
In many ways it doesn't matter what kind of strategy is used, as long as the student
doesn't just sit and "read."
Improving concentration does require significant behavioral change because you
have to work against long established habits. However, a little bit a success in
this area can encourage more change. If a student performs slightly better or feels
better during a test following a period of time of trying distributive practice, then
he will be much more likely to also attempt other strategies.
Managing Test Situations
Some people seem to have a "knack" for taking tests, they know how to figure out
questions and seem to relish the opportunity to show off while taking tests. I recall a
professor in a "Tests and Measurements" class telling a story about a test-wise person
taking a test in a foreign language that he barely knew, yet earning a passing score
because he had an effective strategy. School anxious students know all too well that there
are people like this, and it frustrates them even more. But by teaching our students a few
of the "tricks" about managing test situations, they can improve their performance, even if
it is only a couple of points at a time.
The easiest way to improve the test taking skill is to have students take practice
tests. When possible, these practice tests should be directly related to the actual subjects
studied. The tests can be obtained in a variety of ways: publisher made sample tests,
previous tests from the instructor, review questions at the end of the chapter, test
questions written by the student as part of a study routine (the method preferred by this
author). Students are then instructed to pretend it is an actual testing situation, set up a
clock and go. In addition to practice at taking tests, it is a good study check to determine
which areas need more work. Sample tests work well with study groups because the tests
can be "graded" and discussed by the group.
29
One of the most common complaints of test anxious students is that, "I got
worried about the time. I didn't think I could get it done on time, so I hurried, got more
nervous, and really blew it." Because of the hurrying some mistakes are made on
questions that probably could have been completed successfully. So the first thing
students need to be taught and practice using is a time management strategy, including the
following:
1. Set a Time Budget. This means glancing through the test and estimating how
much time is available for each section. Now this can backfire when a testanxious student calculates that a 100 item test in a 50 minute class period works
out to 30 seconds an item, but generally instructors give tests that can be
completed in a reasonable time period. Setting the time budget prevents a student
from over expending time in one area at the expense of another.
2. Develop a Skipping Strategy. At times our mind set dictates that we complete
one question before moving on to the next, and this pattern is hard to break. But
if a student goes in with a deliberate plan, then the probability of actually skipping
questions goes up. Students can then be instructed to follow a pattern something
like this:
a.) Read the test question. If you immediately recognize the answer or how to
complete it, go ahead and answer the question. Under no circumstances
should you ever return to this question. Go to the next question.
b.) If you think you know how to do it, go ahead and give it a try. If you are
unsure of your answer when completed, put a "?" next to the item
number. You will return to this question if time permits.
c.) If you don't have the slightest idea how to proceed, place a "--" next to the
question and skip it. You will return to this question if time permits.
d.) Once you have gone through the entire test and answered as many questions as
possible, then go back to the items with a "--". These are the ones that
were skipped completely. Sometimes in the process of taking a test your
thoughts will be triggered and you can now answer these. Answer as
many as possible.
e.) After going through the skipped items then look at the ones with a "?"
Change these answers only if you have a strong reason. You probably got
it right the first time.
3. Use the Entire Time. It is quite intimidating to have the smartest student in the
class complete the test early and walk out, this sometimes will unravel a test
anxious student. One way to counteract this is to start with the mind set to use the
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maximum time allowable, and plan to be the last student out the door. This is
especially helpful if the student is one who is a constant clock watcher.
In teaching the test time management strategies it is best to demonstrate them,
then give the student adequate opportunities to practice them until they become
automatic. Without the practice, the student probably will abandon them during the stress
of the testing situation.
One of the next skill areas in taking tests is to learn how to look for key words in
the question and directions (how often do students make major mistakes by not reading
the directions). These key words can change the entire meaning of the question if
misinterpreted. An anxious student in his haste may skip or misread certain sections.
Teach this student to underline the key words in pencil to keep his attention focused on
what is really essential. If it is a multiple choice question the key words in each
alternative will determine whether that choice can be eliminated. Consider the following
sample question with the key words underlined:
Test anxious students often have their minds go blank during a test. Which of the
following is the best explanation for this phenomenon?
("minds go blank" is the construct being requested. "best explanation" suggests
that there could be more than one answer that has some element of truth.)
a.) In preparing for the test the student has tried to remember too many facts and
the brain can't handle the information overload. (This suggests that the
information going into the brain is the problem, possible, but not very
likely)
b.) Most test anxious students have poor study habits and don't know the material.
(Word "most" makes this an absolute type of statement, which is very hard
to make true, even though it may be a portion of the answer)
c.) As a result of the excited physiological state there is reduced blood flow to
certain parts of the brain, interfering with the thinking processes. (The
blanking described in the question is an internal brain process, this is the
only item that is internal, making it the correct one.)
Some study skills or test taking texts will spend a great deal of time analyzing the
nature of certain words in questions and how they impact the correct response and this
may be helpful to many students. However, a lot a students will not spend the time to
become sophisticated test takers. The simple step of underlining is designed to keep their
attention appropriately focused, what they do with the question is left up to their own
cognitive processes.
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One final area in test taking worth noting is how to better organize responses to
essay questions. As a teacher I have had to correct student essays that had a great many
cross-overs, arrows pointing to another section, notes in the margins, and other confusing
scribbles that have frustrated me and demonstrated that the student did not use any
planning in the development of the essay. Test anxious students in their haste will
quickly start writing an essay, only to learn that they have forgotten something important.
Or they will freeze up and not know where to start. One relatively simple strategy is to
have the student read the question and first write a short outline of the response before
writing the final essay. The advantage of this approach is that is forces the student to
think through the entire essay before writing and gives the teacher a preview of what to
expect in the essay (after reading piles of essays most teachers would do anything to have
their student do this because it makes grading so much easier). The following is an
example of this strategy:
Explain the reasons why AIDS appeared to suddenly come out of nowhere and
generate so much fear and resentment in the general population.
OUTLINE: Intro: What is AIDS.
How is it Spread.
Why it "appeared so suddenly"
Body: Explanations of population reaction
Homosexuality
Fundamental Religious beliefs
Lack of accurate information.
Conclusion: Restatement, possible solutions.
AIDS or Acquired Immuno Deficiency Syndrome is a disease that disables
the body's natural defense mechanism against infection and other diseases. At
the present time it is believed that is can only be spread through the direct
exchange of body fluids such as blood or semen.............
Completing the short outline gives the test anxious student a few minutes to settle
down prior to starting the essay and forces him or her to operate in an orderly manner.
And even if a student runs out of time and only has a portion of the essay completed, the
instructor may give the student some credit based on the clarity of the outline. It is also a
relatively easy technique to remember and master.
Assertiveness and Lack of Responsibility
Of the four main study problems highlighted in this chapter, this is the most
difficult to explain and develop strategies for change. Just like the passive stance taken in
reading, many school anxious student tend to accept passive roles as students; they let
things happen to them, rather than taking charge of the learning situation. Manifestations
of this include: blaming the teacher for their learning problems, a fear of negotiating with
32
the teacher or developing a special learning contract, a desire to quit rather than continue
to fight it out.
This passiveness may be the result of a realistic assessment of their learning
performance to date. Years of learning problems and failures tend to erode one's
confidence. The counselor or teacher's role is to work with the student to create some
successes or at least the illusion of making progress. At times a "placebo effect" is
operating when the student finally takes some steps to correct the problem, he or she
begins to have confidence again, starts taking more aggressive action, and the success
begins to snowball. But the key is to make the student believe that he or she does have
some control over the learning situation. The following are some steps that can be taken:
1. Teach the student how to negotiate a special learning contract. Many students
do not understand their options as learners and totally accept what the instructor
requests that they do. However, some students who have problems taking tests or
giving oral presentations may wish to try to set up options to those methods of
evaluation by negotiating with the teacher. It is possible to arrange: a paper
instead of a test, extra credit assignments, the option of taking the test in a neutral
testing center rather than the classroom, an essay exam instead of a multiple
choice, etc. It is adviseable to practice the negotiating with the student prior to
presenting the option to the instructor.
2. Try cognitive restructuring techniques. There may be some faulty thinking
involved because of all the years of school anxiety the student has experienced.
By replacing the negative thoughts with positive ones the student will feel more in
charge of the learning situation. Have the student recall (or imagine while in a
relaxed state) a particular school situation that made her anxious, and record the
self talk. For example, the following would be the example from a test anxious
student who is having trouble in math who reacted when an instructor made an
assignment from a new chapter:
"That a turkey! How can he give us a new chapter when he hasn't taught
us anything from the first one? If I weren't such a dodo I would have
dropped this class the first week and taken it from Dr. Jones. At least he
will work with a person, this guy won't. I won't be learning anything."
The tone of this self-talk is that the instructor is reponsible for the learning, not
the student. In order to think more positively and accept responsibility for ones
own success, the student will need to change her thinking into expressing the
belief that she controls the learning situation. Through counseling, speaking,
writing them down and listening to them, she can change her thinking into
something like this:
"I don't like this guy, but at least I can put up with him. Maybe it is best
that he doesn't explain everything that happens in class, that at least gives
33
me the incentive to try out some new problems and learn from them. I
know that if I continue to do my homework I will do a good job with this
class. With the textbook I can practically teach myself."
This self-talk will certainly not guarantee success for the student, but it does
increase the probability that he or she will believe that they control their own
destiny.
In summary, this chapter on study skills was not attempting to cover all the variety
of items and strategies that can be found in a semester long study skills class. Instead it
was attempting to highlight four particular problem areas characteristic of school anxious
students: Managing and Controlling Time, Concentrating and Remembering, Managing
the Testing Situation, and Assertiveness and Accepting Responsibility. Persons needing
more detail information on study skills should be referred to a study skills class or text.
Selected References
Devine, Thomas G.; Meagher, Linda D. Mastering Study Skills: A Student Guide.
Prentice Hall: Englewood Cliffs, NJ, 1989.
Ellis, David B. Becoming a Master Student: 5th Edition. College Survival: Rapid City,
SD, 1985.
Hoehn, Lilburn P.; Sayer, James E. Keys to College Success. Mayfield Publishing:
Mountain View, CA, 1989.
34
CHAPTER FOUR
SYSTEMATIC DESENSITIZATION AND OTHER BEHAVIOR
THERAPIES
The most popular approach to the reduction of school anxieties has been
"systematic desensitization by reciprocal inhibition." I have found that students love to
hear this phrase and impress their friends by saying that they are experiencing it. In
simplistic terms it is a step by step breaking down of fears (systematic desensitization) by
relaxation preventing the physiological response of anxiety (reciprocal inhibition). If the
physiological response is inhibited, then the person will not be able to feel anxious
because the intensity of the physical cues are no longer present. Also inherent in this
approach is the belief that anxiety is a conditioned response. Somehow we have learned
to be anxious in certain situations and a particular stimulus (i.e. a test situation) will
evoke the complex chain of behaviors that we call anxiety. If we can de-condition a
person to that stimulus then we can break the automatic sequence of behaviors leading up
to the anxiety reaction. Frequently the anxiety can be a result of a single traumatic event
that evoked a very strong physical and emotional reaction, such as being ridiculed in front
of the entire class in second grade for messing up a spelling test. Or from a gradual
reinforcement over time from always doing poorly on math tests.
The purpose of this chapter is to provide a "how to" guide for conducting
systematic desensitization. However, it should not substitute for a thorough knowledge
of the theoretical constructs involved in this process. I strongly recommend that prior to
trying out this process that you read one of the "classic" texts on the approach (Wolpe,
1982; Krumboltz and Thoresen, 1976) and that you observe and have contact with
someone with experience conducting this type of therapy. It is relatively easy to do, but
consultations with others can help a great deal.
When some people first encounter this therapeutic approach they consider it very
elaborate and don't realize that they probably have done it on themselves or with someone
in their family. Let me cite the following example from my family:
35
When my daughter was six she was taking swimming lessons through the local
park district and the lessons were conducted at a beach area that was an old
quarry. There were small fish in the water that occasionally nipped the swimmers.
One day I noticed her sitting on the sand while the rest of her class was in the
water having a great time. After some coaxing she told me that she had been
bitten by a fish and was afraid to go back into the water, in fact she was never
going into the water again. I was tempted to just throw her in the water and say,
"they won't hurt you!" (emotional flooding therapy?). But instead I decided to
take a more cautious approach. Later that day just she and I went to the beach.
We sat on a bench about 100 feet from the water and just visited for a while until
she was comfortable. Then we moved a little closer and built a sand castle until
she was relaxed about being close to the water. Then we walked along the beach
with our toes in the water until I could tell she was still feeling relaxed. Next, I
sat in the water with her on my lap. We sat there until we could see a couple
small fish swim by and she could see just how small they were and until she felt
safe. After that we played a game with me throwing her a few feet away and
making a big splash. Before long she was going on her own and having fun, no
longer afraid of the fish.
Nearly every parent has conducted this type of "therapy" with their children, and
the systematic desensitization approach isn't much more complex. It is an approach that
is easily learned and applied. It can also be used in combination with other types of
treatment. In this chapter three type of desensitization approaches will be discussed: a.)
Traditional desensitization given on an individual basis through the use of mental images.
b.) In Vivo desensitization which involves directly experiencing the fearful situation. c.)
Variations of desensitization by using group methods or audio tapes. The first approach
will be discussed in greatest detail because the other two are variation of the traditional
desensitization approach.
Traditional Desensitization
One of the common ways in which we deal with our fears on a day to day basis is
to face them. For example, if we are afraid of meeting new people, we tend to eliminate
that fear by forcing ourselves to be in situations where we are likely to encounter new
people. If we were to run away and totally avoid these types of situations it would
strengthen the intensity of the fear and the control it has over us. In his clinical practice
Wolpe (1982) found that some fears were so great that people couldn't even begin to
approach them without getting tremendous anxiety reactions. So prior to approaching the
real source of the fear he would have the person imagine the real situation and gradually
work up to an actual encounter. He found that persons who had gone through this
imaginary process had reduced levels of anxiety once they came to the real situation.
From these observations the systematic desensitization through mental images approach
was developed.
36
Although initially designed for severe phobias it has been very popular in schools,
particularly in the reduction of test anxiety. For many types of school fears it is possible
to directly confront the fear through exposure in the classroom, but that is harder with
tests because the student can't get the "real test" until the day of the exam, they can only
surmise what is on it. So the element of uncertainty heightens the reaction. Over time
they develop an almost automatic reaction to any test.
The treatment process goes in three stages:
1.) Initial assessment and the development of hierarchies.
2.) Instruction in deep muscle relaxation.
3.) Pairing the relaxation with presentation of the steps from the hierarchy.
1.) Initial assessment and the development of hierarchies. The first step in any
treatment process is to get a good picture of the nature of the anxiety reaction and develop
a hypothesis about the sources, so a detailed interview is essential (see the sample
interview in Chapter 2). Because you must determine if the student actually needs to
participate in the desensitization. If the poor performance is due to insufficient study
hours or great stress in his personal life, the desensitization may be a nice exercise in
relaxation without any real impact on performance. The students who benefit the most
from desensitization are those that exhibit some element of automatic anxiety reactions to
the fearful situation.
As part of the interview process you begin to develop a sense of the types of
situations that cause the reaction as well as the intensity of the reaction. A hierarchy is
nothing more than a rank ordering of anxiety producing situations from no anxiety to the
highest level of anxiety. For example, "Being at home studying" generally produces little
or no anxiety, while, "Reading a test question and having your mind go blank," represents
a very high anxiety producing situation to the test anxious student. Hierarchies are
usually developed by coming up with a great many behavioral descriptions of situations at
various anxiety levels, then having the student rank them from highest to lowest.
Clinicians will use the term, "Subjective Units of Disturbance" (or SUDS for short) to
represent the intensity of an anxiety situation. SUDS are nothing more than a scale from
0 to 100, with 0 being no anxiety and 100 being the highest level of anxiety. Clients are
presented with situations and asked to place a SUDS score on it. Improvement is shown
when a situation that once was given 100 SUDS is later ranked as a 60.
The following graph is a visual representation of what happens in the
desensitization process as improvement in shown and the anxiety to particular situations
is reduced. In time the SUDS for each drops down one step:
37
The number and intensity of each step depends on the strength of the anxiety
reaction. Mild anxiety reactions (which most school anxieties are) may only require a
few steps in a hierarchy (5-10) to go from the lowest to the highest level. The more
severe phobias that would be found in a clinical setting may require more steps (20 or
more) and smaller increments to go from the lowest to the highest. The simplest way to
construct a hierarch is together with the student brainstorm a number of situations, then
group them into categories of "high", "medium", and "low." The final hierarchy is
developed by getting a few from each category. If the student is having a hard time
working up the scale, then a few more steps should be added to the hierarchy. For
example, the following is a typical eight step speech anxiety hierarchy:
1. At home studying.
2. Writing out note cards for a speech.
3. Waking up and getting dressed the day of a speech.
4. Going to sleep the night before a speech.
5. Driving to school the day of a speech.
6. Giving the first few lines of a speech successfully.
7. Walking up to the front of the room to give your speech.
8. Starting a speech and having your mind go blank.
Part of the key to developing effective hierarchies is to make them very specific to
the experience of the person. Each one of us experiences our world differently. What
produces great anxiety in you may not do the same for another person. So the hierarchy
must be based on the unique situation of your student. One effective way to check the
ranking is to get the student relaxed and ask him or her to imagine each one of the
situations and then immediately write down a SUDS score.
38
2.) Instruction in deep muscle relaxation. Nearly any kind of relaxation strategy
can be used with the desensitization and there are scores of scripts and approaches
available to a counselor. The key, however, is that the student must develop deep
physical relaxation in order to have the counter-conditioning effect of reducing the
automatic anxiety response. This author prefers the method that involves alternately
tensing and relaxing the muscles of all parts of the body, paired with effective breathing.
A sample of this script and a short deep breathing exercise are found in Appendix A or
audio tapes may be ordered from the author. This deep muscle relaxation script is
preferred because the students using it get very immediate positive feedback. Nearly
every student on the first try will find themselves getting very relaxed. It is not
uncommon to have a student report that he or she can never recall being that physically
relaxed. With repreated practice, which is essential, the student can quickly get into a
very deep state of physical relaxation. However, it bears repeating that any relaxation
method chosen by the counselor or student will be effective if it induces the deep muscle
relaxation.
Prior to using a relaxation method with students it is necessary that the counselor
practice so that the pacing and voice tones are appropriate. The tendency is to say too
much, talk too quickly, and not reflect relaxation in your voice. Once students learn to
relax effectively they need fewer verbal cues from the counselor. I can recall listening to
relaxation scripts from other counselors and having the thought, "Please be quiet and let
me relax!" go through my mind. Practice on friends, family or colleagues and they can
give you feedback on how you are doing. Tape record yourself and try experiencing your
own script. It is good to give students a cassette tape of your relaxation script for them to
take home and practice.
The relaxation may take place with the student sitting in a comfortable chair or
lying on the floor if they are able. Generally lying on the floor is preferred because it is
easier to fully expand the chest and stretch the muscles, but in many settings the floor is
too hard for the students. Dim the lights and turn on a fan or some other device to create
some "white noise."
3.) Pairing the relaxation with a presentation of steps from the hierarchy. This is
when the actual de-conditioning occurs. Everyone does derive some significant benefit
from learning how to physically relax, but this step permits this deep relaxation to inhibit
the automatic anxiety reaction. In short, you have the student imagine vividly in his or
her mind the situations that create anxiety while their body is physically relaxed. You
start at a low level and work up to the highest level of the hierarchy until the scene can be
imagined while staying totally physically relaxed. When this is accomplished the
intensity of the anxiety reaction in the real situation is reduced and hopefully performance
is improved.
One critical element in this process is the ability of students to create vivid mental
images. In our video generation people are accustomed to having images presented to
them, rather than generating their own. Many students need practice in developing clear
39
images. Several strategies can be used to facilitate this, the most common is to have the
counselor present guided imagery while the student is relaxed. Coming from the midwest
I frequently take students on a "walk in the woods during the Fall." I describe the sights,
sounds, and smells of that experience. The more students can attempt to bring in the use
of all of their senses, the more vivid the images will become. Another effective strategy
is to have students work on their own "neutral scene." This is a personal scene of
themselves doing a favorite relaxing activity, such as: sitting in an easy chair listening to
favorite music, lying on the beach, taking a hot bath, sitting by the lake, etc. These
should be passive activities and the student can practice making these images as vivid as
possible. I use this neutral scene are part of the process of presenting the steps in the
hierarchy, but it can also be used at other times as an anxiety management tool; just
thinking about this neutral scene will become a conditioned stimulus for relaxation and
can be used when the student is actually experiencing anxiety.
Once ready, the therapy generally proceeds in the following manner, but many
variations on the theme exist:
1. The student is put in a relaxed state through the use of a deep muscle relaxation
script.
2. They are asked to imagine their neutral scene for a short period of time to
enhance the depth of relaxation.
3. The first scene is presented and the student imagines it for a short time (15-45
seconds).
4. The student is asked to stop imagining that, relax, and go back to the neutral
scene.
5. The first scene is presented again.
6. Relaxation.
7. The second scene is presented.
8. Relaxation.
9. The second scene is presented again.
10. Relaxation.
11. The student is brought out of the relaxed state by first wiggling toes, moving
feet, moving hands, then opening eyes and sitting up.
12. The counselor and student discuss the session and evaluate the experience.
Usually two steps on the hierarchy are presented each time, going one step higher
each time so that each scene is presented twice (i.e. at session one you cover 1 and 2,
session two covers 2 and 3, etc.).
The length of time of the presentation depends on the intensity of the anxiety and
the reaction of the individual. If a person feels very anxious while imagining the situation
the presentation may be very short the first time it is given. For most school situations,
this author uses a presentation of about 30 seconds. It is critical that you not go higher on
the hierarchical scale until the person can remain fully relaxed while imagining the scene.
You want to reinforce the feeling of relaxed control over the anxious situation. As a
40
counselor you must control the pacing of the therapy so that you proceed only when the
person is ready. Many counselors will have the person signal them when they are feeling
anxious while imaging a scene by having them raise a finger of their hand (they are too
relaxed to waive a whole hand!), and when the signal is given the student is immediately
instructed to go away from the scene and relax. The anxiety they feel will manifest itself
in small physical ways: eye twitch, change in breathing, tightening in stomach or
shoulders. Later in the session or in a subsequent session, the scene can be presented
again. If the person can't get past this point then you probably have a problem with your
hierarchy and need to generate some additional low level scenes.
For a complete script of a desensitization session check in Appendix A or order
the audio tapes from this author.
In Vivo Desensitization
In Vivo desensitization means using this same step by step process, but in real
situations rather than through mental images. In most clinical situations this is the
preferred method because the results are more dramatic and rapid than when using mental
images. It is frequently called "Exposure Therapy." (Greist, 1986). The mental images
are only used when the real situation is so threatening that it cannot be approached; and
the use of systematic desensitization is used only to prepare the client for the In Vivo
approach.
In this method hierarchies can be constructed in a similar manner as in the mental
image approach, but with the expectation that these will be actual behavioral situations.
Students are taught "Anxiety Management" strategies so that they can relax and think in a
positive manner when they start to feel anxious. The student starts on the first step of the
hierarchy, if he feels anxious then he will apply the relaxation strategy before proceeding
on. Speech anxiety is one of the areas that quickly responds to this method. The
following is an example of a heirarchy that could be completed In Vivo:
1. Preparing notes for the speech at home.
2. Practicing the speech at home in front of a mirror.
3. Giving the speech to a friend at home.
4. Going into the speech classroom when it is empty, not on the day of the speech.
5. Practicing the speech in the empty speech classroom.
6. Driving to school the day of the speech.
7. Entering the classroom the day of the speech.
8. Walking up to the front of the room to give the speech.
9. Hesitating during the speech to collect your thoughts.
As the student is experiencing the situation he or she will apply a relaxation
technique, such as controlled deep breathing, when the physical symptoms of anxiety
41
appear. Once back in control the student proceeds onward. This In Vivo approach is
usually paired with a cognitive strategy (discussed in greater detail in the next chapter) in
which the student attempts to block negative thoughts and has already thought out in
advance a coping strategy that to use when anxious.
Another common desensitization technique that is in reality an In Vivo approach
is what is called, behavioral rehearsal. Behavioral rehearsal simply means practicing or
simulating what you are going to experience so that when you actually get into
the situation you know what to expect. For example, one the best preparation techniques
for test anxious students is to take a lot of practice tests. This is mentioned as a good
study strategy in the chapter on study skills, but it has its roots in behavior therapy.
Actors avoid stage fright and losing lines by going through the parts so many times that
they become automatic and they begin to think like the character they are portraying.
Students with writing anxieties are stimulated to write more through the practice
technique called, "free writing." New situations and experiences are scary, by using
behavioral rehearsal it becomes much less frightening.
Audio Tape and Group Presentations
Traditional behavior therapists might shudder at the thought, but one of the most
practical ways to conduct systematic desensitization in school is through group or audio
tape methods. In most school settings a counselor or teacher simply does not have the
time to conduct individual desensitization. A compromise must be made in the
traditional approach to do it with small groups of students with similar anxieties or to
provide a set of audio tapes for students to use on their own. Certain adjustments in
methods must be made:
1. "Average" hierarchies must be constructed. By using a group average ranking
or a sampling method, construct a typical hierarchy. Since students share many
similar experiences in school, an average hierarchy is rarely far off from the
hierarchy of any individual.
2. An individual treatment a student can signal you when he or she is having
difficulty with a particular scene. In a group or audio presentation students can be
instructed to leave a scene and go back to relaxation if they are having difficulty
with it, even before the group leader tells them to relax.
3. Not everyone goes at the same pace through the hierarchy. In a group setting,
those students who are lagging behind the rest can be given extra make-up
sessions. Using an audio tape presentation, students are instructed not to go to the
next higher level until they can listen to a tape and stay completely relaxed.
As will be seen in the chapter on model programs for the various school anxieties
(Chapter 7), this author actually prefers group methods over individual work. In a group
42
setting you can include a wide variety of behavioral and cognitive instruction to deal with
all aspects of the anxiety. Plus with a group you have the natural support that comes from
the other members of the group, it is good to know that you are not alone. By talking
with the other students, an individual realizes how common school anxieties are, and they
are not simply going crazy.
The audio tape presentation is probably not quite as effective as a live presentation
because it lacks the immediate human touch of the counselor or teacher, but still is a very
effective alternative. Schedules and time commitments at times make it impossible to
bring all students into groups. Some student may also prefer to do the work in the privacy
of their own homes. Good quality sound production is essential, simply taping a live
group session will result in a tape that sounds like it was recorded in a barrel. Schools
can record their own and avoid problems with duplication and copywrites, or it is
possible to order tapes from various organizations (a set of test anxiety and speech
anxiety tapes are available from the College of Lake County).
Summary
In summary, the term "exposure therapy" does a good job of describing what
needs to be done: we must face our fears or they maintain control over us. All of the
desensitization models are nothing more than a step by step approach to enable a person
to face the fearful situations and control the anxiety reactions.
Selected References
Deffenbacher, J. L.; Parks, D. H. A Comparison of Traditional and Self-Control
Desensitization. Journal of Counseling Psychology, 1979, 26(2), p.93-97
Greist, J. H.; Jefferson, J. W.; Marks, I. M., Anxiety and Its Treatment. American
Psychiatric Press: Washington, D.C., 1986.
Watson, A. Effects of Systematic Desensitization in the Alleviation of Communication
Apprehension, EDRS # 297-399, April 1988.
Wolpe, J. The Practice of Behavior Therapy, Third Edition, Pergamon: New York, 1982.
43
CHAPTER FIVE
COGNITIVE APPROACHES
As mentioned in Chapter One, this author believes that both behavioral and
cognitive approaches are essential to the effective treatment of school anxieties. But the
cognitive approaches are harder to get at in practical terms. You can observe a person's
behavior and you can measure their physiological responsiveness, but how do you get at
what is going on inside someone's head? How we experience our world is very
subjective and is mediated by our thought processes. Anxiety too is dependent upon how
we mentally interpret the stimuli around us and within our own bodies. If we can modify
that interpretation, then we can modify the experience of anxiety.
One can read many articles in the literature about "cognitive therapy" without
getting a clear idea of exactly what you do with the person. In this chapter an attempt will
be made to provide some practical suggestions about how a counselor or teacher can
apply some of these ideas in the reduction of school anxieties. As with other sections of
this book you are encouraged to read more in depth from the selected readings. It is
possible to classify the cognitive approaches into three categories: 1. Skills Acquisition.
2. Cognitive Restructuring. 3. The Development of Coping Strategies.
Skills Acquisition
The skills acquisition approach is simply to learn what is necessary to perform and
is best described by teaching students how to study. If students study and learn the
material, they will have little or no difficulty in performing in evaluation situations. This
is the classical way of dealing with school anxieties and probably is the way in which the
vast majority of students control their apprehension. Chapter Three deals more
extensively with the study skills issues, but it bears restating because effective study is the
backbone of success in school. The most extensive therapy in the world can do no good
if the student hasn't first mastered the material.
With some of the more specific school anxieties there are particular types of skill
acquisition necessary. The following are some examples of what can be done (more
detailed suggestions can be found in Chapter 7):
44
Test Anxiety: Students can be taught the science of taking tests.
Speech Anxiety: Some people hold the belief that to be an effective speaker all
you have to do is stand up and talk since everyone knows how to talk,
neglecting the science of communication. Students can be taught how to
organize their presentations, analyze the audience, speak clearly, maintain
rapport with the audience, and all the many techniques used by successful
speakers. With greater skill, students generally proceed with greater
confidence.
Math Anxiety: Many students with math anxiety have had that fear for years and
it has affected the acquisition of fundamental mathematical skills and
concepts. Frequently math anxious students are taken back to the very
basic building blocks of mathematics, concepts often taught in elementary
school and junior high school. With a better understanding of the very
basics, they can proceed rapidly into more advanced studies. The complex
math avoidance behavior has meant that poor performance in classes is
partially due to simply not under-standing the material.
You can easily see that nearly any student suffering from a school anxiety can
benefit from some elements of the skill acquisition approach to treatment. With little
difficulty you can make the assumption that all students need this and include skills
acquisition in all treatment plans. However, it is important to not assume that it is the
only reason for the anxiety. The role of the counselor or teacher is to carefully question
the student, examine the behavior, and determine if there are other contributing factors
that need to be addressed.
Cognitive Restructuring
The term "cognitive restructuring" on the surface sounds like this incredibly
complex process that can only occur after years of intense study and psychotherapy.
Nothing can be further from the truth! It is a fairly straightforward and logical process by
which a person attempts to change patterns of thinking and what we say to ourselves. It is
done with the help of a skilled counselor, teacher or therapist, but the control and
responsibility for change rests fully with the individual undergoing the transition.
There is abundant literature on this process, but nearly all roads lead back to
Albert Ellis and his relatively simple approaches to rational thinking. The basic premise
is that if you can eliminate some of the irrational thoughts and beliefs, then you can
change the unwanted behavior. Anyone who has worked with school anxious students
will recognize the following types of statements that are reflective of this irrational
thinking:
45
"I have never done well in school and I know that I won't again this term."
"I simply don't have a logical mind, that is why I cannot do math."
"If I speak up in class I know that I will make a fool of myself and everyone will
laugh at me."
"If I flunk again this semester my parents will kill me and I will never be able to
return to school again. So I have to pass."
"I always screw up on tests, so I have stopped trying."
Students who extensively use this type of thinking and verbalization are bound to
think poorly about themselves and not do as well as they could. We say these things
frequently to ourselves and they are called, "self-talk." In the above statements you can
hear over generalizations in very absolute terms, "I have never done well in school." Or
you can hear people giving themselves very unrealistic goals that have to be met or
something terrible will happen, "I have to pass... or I will never be able to return to
school." Ellis uses such descriptive terms as "musterbating" and "awfulizing" to explain
this type of thinking. When a student is speaking in absolute terms such as this or is
making broad generalizations, he or she would be a good candidate for an examination of
the belief system that is leading up to these statements.
A simplified version of his approach is called the A-B-C theory (Ellis, 1977):
A-Activating Event. This is the particular stimulus that triggers the reaction, such
as having to take a test in school.
B-Belief System. This is the cognitive system that we use to interpret the events
around us, the thoughts can be rational or irrational. An irrational belief
would be, "I never do well on tests, I won't again here, so the teacher will
know how stupid I really am." A rational belief would be, "I haven't done
well on tests in the past, but I have prepared real well this time, and I think
I have a shot at a good grade."
C-Consequences. (both emotional and behavioral). This is the result of the
activating event, which in the case of the test could be good performance
or an anxiety reaction.
It is the belief system that gets the most attention because this is where change can be
made. The activating event (A) does not lead directly to the consequences (C), it is the
belief system that intervenes (B).
In a practical sense in means working with students to identify irrational or
unreasonable thinking, then coming up with alternative beliefs. The "cognitive
restructuring" comes into play when the person is asked to deliberately say the rational
statements to himself in situations when he normally would use the irrational ones. The
46
deliberate use of these self-statements interferes with the surfacing of the irrational
beliefs. The following would be an example of a worksheet that a counselor
might use with a student:
RATIONAL THINKING WORKSHEET
Present Situation
Activating or Stimulus Event: (Have the student describe in as much detail as is
necessary what the triggering event is, such as taking a math test)
My Self-Talk: (Have the student list with in detail all the things that were going
through his or her head leading up to the test and during the test.)
What Happened: (Have the student describe what actually happened as a result of the
event. Success, level of anxiety, etc.)
Desired Situation
What I would like to see happen: (Have the student describe in as much detail as
necessary what he or she would like to have happen the next time.)
Alternative Self-Talk: (Go through the statements listed above with the student and try
to come up with some alternative statements that are more reasonable. Have the
student practice saying them with you.)
On the surface it may seem that this is too simple and that just changing what you
are saying to yourself cannot possibly impact the school anxiety. Taken in isolation, just
changing the self-statements probably will not significantly change school performance.
47
But when used in combination with things such as skills acquisition and desensitization,
it can be a very powerful tool.
The Development of Coping Strategies
A logical enhancement of the general cognitive approaches is the "coping
strategies" approach that attempts to bring together the cognitive and behavioral methods.
The general assumption is that anxiety will occur and that everyone will experience some.
What is critical is what the individual person does with the anxiety. Persons can be
taught how to cope with the anxiety and manage the situation. Deliberate and advanced
planning helps reduce the intensity of the anxiety, prevent it from happening, or shorten
the time period. Three different authors will be highlighted here to show this "marriage"
of cognitive and behavioral approaches.
Donald Meichenbaum (Jaremko and Meichenbaum, 1983) uses the term, "Stress
Inoculation Training," to describe a planful approach to dealing with stressful situations.
Most of the applications have been made in clinical settings, but a useful corollary can be
made for school anxiety. The basic model is as follows, with examples from school
settings:
PHASE ONE: CONCEPTUALIZATION
In this segment the counselor and client try to develop a mutual understanding of
the problem in order to plan for the skills acquisition phase. The key here is
mutuality, both parties carry the responsibility for success. Data are collected and
the client is taught how to continually analyze the problem. In the case of school
anxiety the student and counselor will come up with a clear understanding of the
situations in which it occurs and the intensity. One method used to collect data
are "image based reconstruction." Instead of relying purely on self-report, the
student is placed in a relaxed state and asked to imagine the anxiety producing
situation. In this relaxed state the student may recall details about the event or
self-talk because he is re-experiencing the event. The counselor can then record
the comments from the reconstruction. A student will also be taught to keep a
diary or log of events and feelings surrounding the anxious situation.
48
PHASE TWO: SKILLS ACQUISITION AND REHEARSAL
The student is trained in coping skills that involve doing something (better study
strategies, test taking, relaxation) as well as how to think in the situation
(perspective, self-statements, emotional supports). And then the skills are
rehearsed. Rehearsal has to be the key. Frequently schools will provide one
session workshops for student on subjects such as study skills, test anxiety, stress
management, etc. But little attention is paid to actually practicing these skills.
Skills that are not practiced and practiced over time are generally not acquired.
As part of this instructional phase students should be taught how to self-monitor
and maintain the skill.
PHASE THREE: APPLICATION AND FOLLOW-THROUGH
After the skills have been practiced they need to be applied in real situations. It is
possible to phase this in by using In Vivo desensitization procedures if necessary,
or by using realistic role-playing and practice. The student is also taught to
recognize the cues that are present at the onset of an anxiety reaction. For
example, if a student always gets tight shoulder muscles just prior to a test can use
that as a cue to start using relaxation or positive self-talk. Regular follow-up is
necessary to monitor the progress of the student as well as the self-monitoring by
the student.
Ottens (1989,1984) essentially used Meichenbaum's model and built an approach
specific to dealing with school anxieties that emphasized learning particular coping
strategies by dividing it into a four stage model:
STAGE ONE: Problems that can arise.
The problems are divided into one of four categories:
Misdirected attention or attentional difficulties.
Presence of interfering thoughts, self-talk, or other disruptive mental activity.
Presence of physiological/emotional distress.
Inappropriate behaviors.
STAGE TWO: Awareness (Early Detection System).
Become aware of the existence of problems as quickly as possible (early
detection). Let this early awareness act as a signal to employ coping responses.
STAGE THREE: Employ Coping Responses.
Choose appropriate coping responses, singly or in combination.
49
STAGE FOUR: Reapply Coping Responses as Needed.
Reapply the coping responses of stage III or choose a different combination, as the
need arises.
The heart of this model is the early awareness and the application of the
appropriate coping responses. It accepts the fact that a person will get anxious and moves
quickly to, "what are we going to do about it?" In working with a student the counselor
or teacher needs to help in the identification of appropriate coping responses and teach
them to the student. Ottens and others developed a scale of academic coping that presents
25 critical incidents that occur in college situations and lists 6 possible coping responses
for each, three functional and three dysfunctional. Students are then asked to rate how
often they use the strategy. The scale assesses the appropriateness of student strategies,
but also serves to teach the student coping strategies. Consider the following example
from the scale (used with permission of the author):
When I start feeling physically weak or nervous during an exam,
_________________
a.) I worry that the weakness or nervousness will get worse.
b.) I remind myself that those feelings are normal and needn't upset me.
c.) I start to pay more attention to how I feel than what the exam questions say.
d.) I set aside a few moments to relax and calm down.
e.) I try to push away the thoughts about how I feel and concentrate harder on the
test.
f.) I wait and hope the feelings go away.
(you will note that b, d, and e are functional)
The thinking behind this approach is that students need be be aware of their
functional and dysfunctional behaviors and that they can elect to use more functional
approaches. Advanced planning and preparation for the situation is essential. Obviously
many behavioral methods will be employed using this model, but it is essential a
cognitive one because of the advanced planning that is employed. An example of using
these functional and dysfunctional coping responses to critical situations can be seen in
the test anxiety workbook prepared by this author.
Another effective variation on the cognitive theme is the communication
apprehension approach used by Watson (1986; Kelly and Watson, 1989). Assessments
are conducted to determine the source and nature of the anxiety. Different treatments are
arranged depending on the nature of the problem. If there is a low self-acceptance then
students are given information and practice in using the Ellis A-B-C model of rational
thinking. Students with a high level of communication apprehension complete a
50
systematic desensitization using an audio tape presentation or through the development of
an individual hierarchy. And finally, students with various skills deficits are remedied
through a process of setting and evaluating various communications goals. The following
is an example of one of these plans dealing with interpersonal communication skills
(1986):
Step A. Define goal areas:
Be a better speaker.
Step B. Formulate specific goal statements:
Learn to start, continue and end a conversation.
Step C. Criteria for success:
I want the listener to answer my questions and respond with a smile.
Step D. List the steps in preparation:
Monday, Sept. 25, in English class I will talk to that blonde girl. I will go
the the class early. To start, I will say a friendly, "Hello," and ask her how
she likes the class. To end, I'll say, "Nice to meet you. If we have any
class problems, let's get together."
Step E. Plan for contingencies:
If the girl is not there Monday, I'll talk to her on Wednesday. If she doesn't
answer me, I'll plan to talk with someone else.
After the completion of the goal it is evaluated and discussed with the student.
The key to this cognitive model is that is doesn't assume that all students have the same
communication apprehension difficulties, so you target the needed activities depending
on the situation. It is also a very planful process. In the goal setting component students
analyze their difficulties and plan in advance how to cope with them. And as in the
Meichenbaum model, there is evaluation and monitoring conducted by the student him or
herself. More detailed examples of using this model are found in the Chapter 7.
Summary
In conclusion, this chapter on cognitive approaches to school anxieties has
attempted to distill some of the theories on cognitive therapy into relatively simple
models. It should be evident that problems in thinking and planning do negatively impact
performance in school. By teaching students very specific coping strategies they can
better manage and control the anxiety producing situations they encounter.
51
Selected References
Beck, A. T.; Emery, G. Anxiety Disorders and Phobias: A Cognitive Perspective. Basic
Books: New York, 1985.
Ellis, A.; Grieger, R. Handbook of Rational-Emotive Therapy. Springer: New York,
1977.
Ellis, A.; Harper, R., A New Guide to Rational Living. Prentice-Hall: Englewood Cliffs,
New Jersey, 1975.
Goldfried, M.; Linehan, M. M.; Smith, J. L., Reduction of Test Anxiety Through
Cognitive Restructuring. Journal of Consulting and Clinical Psychology. 1978,
46(1), p 32-39.
Kelly, L.; Watson, A.K. Speaking with Confidence and Skill. University Press of
America: Lanham, MD, 1989.
Meichenbaum, D.; Cameron, R. Stress Inoculation Training: Toward a General Paradigm
for Training Coping Skills. from: Stress Reduction and Prevention. Donald
Meichenbaum and Matt Jaremko (ed.) Plenum Press: New York, 1983, p.115-154.
Melanson, D. Applied Self-Statement Modification and Applied Modified
Desensitization in the Treatment of Speech Anxiety: The Synergy Hypothesis.
Unpublished Doctoral Dissertation. EDRS # 294-252. September 1986.
Ottens, A. J. Coping with Academic Anxiety. Rosen Publishing Group: New York, 1984.
Ottens, A. J; Tucker, K. R.; Robbins, S. B. The Construction of an Academic Anxiety
Coping Scale. Journal of College Student Personnel. May 1989, 30, p.249-256.
Suinn, R. N. Anxiety Management Training to Control General Anxiety. from:
Counseling Methods. John D Krumboltz and Carl E. Thoresen (ed.). Holt,
Rinehart and Winston: New York, 1976, p. 320-326.
Watson, A. K. "Alleviation of Communication Apprehension: An Individualized
Approach." Texas Speech Communication Journal., 1986, p.3-13.
52
CHAPTER SIX
STRESS MANAGEMENT TECHNIQUES FOR SCHOOL ANXIETY
Start asking your school anxious students questions about their general lifestyle
and how they take care of themselves and you are likely to hear the following:
"My life is crazy at times. It feels like I am constantly running into my house
dropping something or someone off, then turning around and going again."
"I just snack during the day, but I usually eat a good dinner."
"Since my divorce I have found myself worrying a lot more about everything:
money, the kid's behavior, being alone......"
"I get so sleepy during class, there must be something wrong with me.
"Between my job, what my parent's want me to do around the house, doing things
with my friends, there just isn't enough time for me to do my homework."
Our students lead stressful lives and that stress does have an impact upon school
performance. Now it cannot be said that stress causes anxiety, because many students
deal with a great deal of stress and show little or no signs of anxiety. However, it is quite
clear that students experiencing school anxieties frequently show signs of stress-related
problems and difficulties in managing their lifestyles. Learning to better manage stress or
to modify certain elements in their lifestyles will increase the likelihood that the school
anxiety can be controlled. To put it in more direct terms, nearly all the students that this
author encounters with school anxieties also have lifestyle management problems,
especially with their diet and the pacing of their life. This is so prevalent that all students
receive information and/or practice changing stressful lives. In particular, the following
are some of the areas that need to be addressed: Diet and Eating Patterns, Exercise,
Managing Time and Life Pacing. There are many more areas to the field of stress
management, but these in particular are the ones that seem to appear more frequently
among school anxious students.
53
The stress management literature is abundant, so abundant that one can get
"stressed-out" simply trying to decide which is best. This author recommends those that
are multi-dimensional, meaning that they suggest that you use a variety of methods. For
example, a book that suggests you manage your stress simply by learning to relax would
probably not be very helpful. Materials that encourage the all aspects of the problem are
more likely to have an impact and actually change behavior. There is also a tendency to
encourage an "all or nothing" type of change in behavior or beliefs. Yet knowing human
nature, very few people can totally change their lifestyle, so materials that encourage
incremental change probably are more realistic. But in general, being well versed in
stress management strategies as outlined by a multitude of excellent authors will help in
work with school anxious students.
Diet and Eating Patterns
In looking at dietary issues one must look at both what people eat, as well as when
they eat. Although there are great differences in tolerance, humans need regular
consumption of good food in order to operate at peak efficiency. Going to school is a
physical as well as cognitive experience and students need good energy levels in order to
think. Blood sugar is what fuels the cells of our body and the regulatory systems within
the body seek to maintain a homeostatic condition. Blood sugar is derived from the foods
that we eat. During times of sympathetic arousal (see Chapter 1) our body calls for
increasing quantities of blood sugar to power this excited state. A stressful situation,
such
as taking a test, will result in sympathetic arousal and will start to deplete bodily "fuel
reserves." A student who has not eaten much since dinner the day before and who has a
1:00 p.m. test is at a distinct disadvantage. Because of their already existing disposition
to performance problems, school anxious students are even more vulnerable to low blood
sugar.
One common response to low blood sugar is to snack, we all do it. We eat foods
high in sugar or carbohydrates that are easily digested and quickly converted into blood
sugar. When you are hungry and eat something like a candy bar or a coke, it does make
you feel better. Unfortunately, there are consequences to this. The sugars that are rapidly
absorbed into the blood stream are also rapidly depleted, starting the whole cycle over
again. If we continually shove sugars down our throats our body reacts in a desire to
maintain a homeostatic state and secretes insulin, which serves to reduce the blood sugar
level, further confusing us. The only way to counteract this cycle is to have regular
consumption of foods that are digested more slowly and don't result in this rapid change
in the level of blood sugar. This author has seen numerous students report significant
improvement in their school performance simply by changing their habits to include
regular meals.
Caffeine consumption is another factor that can contribute to the potential for an
anxiety reaction. As mentioned in an earlier chapter, one theory for why people feel
54
anxious is that they interpret certain physical cues related to sympathetic arousal as being
the onset of anxiety. Caffeine can mimic this type of arousal by (Manaham, 1988):
stimulating the central nervous system and the heart, and elevating blood sugar levels. It
is fairly common knowledge that persons with tendencies toward anxiety reactions need
to severely limit caffeine intake. Coffee and tea are most commonly pointed to as the
culprits, but rather high levels of caffeine are also found in things such as: soft-drinks,
chocolate products, and analgesic medicines like Excedrin or Midol.
To summarize some of the dietary recommendations, the following actions are
recommended for your students (and you):
1. Increase the regular consumption of food throughout the day. Not necessarily
more calories, but spread them throughout the day. Students in day classes especially
need to eat a good breakfast, just as our mothers always told us. Evening students need to
be careful not to eat a huge dinner before going to class.
2. Increase the consumption of fresh fruits and vegetables. Fresh fruits and
vegetables are high in vitamins, minerals, and complex carbohydrates that are digested
more slowly than with processed foods. Fresh products are better than canned or
processed because the vitamin content is better and there are no added salts and sugars.
3. Increase the consumption of whole grain products such as: whole grain breads,
oatmeal and other cereals. These products are high in the B vitamins (that are depleted
rapidly in stressful situations) and are also foods that are more slowly digested.
4. Maintain adequate levels of protein through consumption of: eggs, milk
products, lean meats, fish, beans, nuts. Caution should be taken not to overload in this
area because many of these foods are also a source of fats and cholesterol.
5. Decrease the consumption of caffeine. Substitute things such as de-caffeinated
coffee and tea, fruit juices, and water for beverages. Fresh fruit in lieu of a chocolate
candy bar.
6. Decrease the consumption of high sugar content foods and beverages. Safer
snack foods such as fruit or low-salt crackers can help, but eating regular meals will also
help reduce the desire for snacks.
7. Decrease the consumption of alcohol and other drugs. In addition to the
impairment of performance, the alcohol is metabolized into blood sugars.
It is relatively easy to talk about these types of dietary changes, it is another thing
to actually help the person change. One step in the dietary change, is to have a better
awareness of what you are actually doing. Once a pattern is observed, then the person can
set a goal for change. One approach is to have students complete a daily eating log:
55
On the following log please list everything that you eat and drink, it will be used to
evaluate whether your diet supports or detracts from your school performance.
Day/Date:
Breakfast
Lunch
Dinner
Snack
Day/Date:
Breakfast
Lunch
Dinner
Snack
Day/Date:
Breakfast
Lunch
Dinner
Snack
Day/Date:
Breakfast
Lunch
Dinner
Snack
Day/Date:
Breakfast
Lunch
Dinner
Snack
Day/Date:
Breakfast
Lunch
Dinner
Snack
Day/Date:
Breakfast
Lunch
Dinner
Snack
56
Once a log has been kept for several days the counselor and student can review it
together. After being supplied with information about an appropriate diet, the student can
then begin to set goals for change. The first thing necessary is to not speak in absolutes.
For example, don't let a student make a goal of, "I will never drink caffeinated coffee
again." A goal like that will probably be violated shortly and all behavioral change
ended. A more achievable goal would be, "I plan to limit my coffee intake to one cup in
the morning." A goal like this has a much better chance of success. Regular checking
and monitoring of the goals set will increase the chances that the student will effect some
change.
Exercise
Exercise has long been used as a treatment for a variety of illnesses, especially
heart disease. But more recently there has been interest in using it as a supplement to
treatment for anxiety and depression (Feuerstein, et.al., 1986). There are two primary
beneficial elements of exercise: 1.) As a general relaxer or stress reliever. 2.) To
strengthen the body to better tolerate future stressful events.
It is regular aerobic exercise that appears to have the greatest benefit. During
aerobic exercise a person's heart rate is brought up to at least 70% of maximum and
sustained for a period of time, usually 20-30 minutes three or four times a week. This
type of exercise is designed to improve general heart/lung efficiency, with the most
popular forms being: running, swimming, rapid walking, bicycling, and aerobic dance.
One way to explain why it has a beneficial effect in reducing anxiety is by
examining the resting heart rate. A well conditioned person has a lower resting heart rate
than a poorly conditioned person. In addition to the lower resting heart rate, the well
conditioned person's heart returns more rapidly to the lower resting state. During
stressful situations the heart rate goes up, anxiety prone individuals recognize the
accelerated heart rate as a cue of an anxiety reaction. If a person can maintain a lower
heart rate or rapidly return to a lower rate, then they are less likely to interpret a situation
as anxiety producing. Therefore the aerobic exercise has increased a person's tolerance
for stress.
Just as with the dietary changes, people are usually aware of the benefits of
exercise, but getting them to do it on a regular basis is a challenge. Exercise "guru's"
spend their professional lives trying to find the secret to unlocking a person's desire to
exercise. How can a counselor or teacher successfully get a student to exercise? The
following are some suggestions:
57
1. Appeal to the practical. Convince the student that regular exercise will increase
the likelihood of success in school. If he or she really wants to graduate, consider getting
involved in a regular program.
2. Model the Behavior. This is a tough pill to swallow, but students of all ages
learn by example. If you want to convince your students of the benefits of exercise, then
you must practice what you preach.
3. Connect the Exercise to Social Benefits. Help the student discover a way to
make the exercise fun. One of the reasons many students maintain involvement in
activities such as aerobic dance, is that they enjoy getting together and dancing with the
other participants. Having a "walking buddy" can be both great exercise and great
psychological therapy.
4. Benefit to Self-Worth. Anxious students are often overwhelmed in their overall
life, and feel that they never have time to do something for themselves. Exercise can be
that activity. Contrary to #3, some persons like to go for a quiet run or bike ride as a way
to pamper themselves and to be alone for thinking.
The changes that come through regular exercise are probably not as dramatic as
the changes that occur with the modification of a crummy diet. It takes considerable time
to significantly improve cardio-vascular conditioning. But once it is improved and
maintained, the physical and psychological benefits are considerable.
Managing Time and Life Pacing
The lament we all hear is, "I just don't have the time to do it all." In many cases
the person is probably right, they don't have the time to do all the things they have chosen
to do. In other situations it is the inefficient use of time that creates this time pressure.
The chapter on study skills (Chapter 2) addresses the issue of organizing school work that
has to be done, and this can be carried over into general life management. Going to
school is just one portion of a student's life and needs to be managed accordingly. This
was driven home when I surveyed 500 students at my community college and discovered
that they averaged less then one hour of study for every credit hour taken. School often is
simply one of many priorities in a person's life.
The primary recommendation in the study skills section was that a student use a
calendar to list all major events, assignments, duties, etc. Using this method there are no
surprises and the person will tend to focus on what needs to be done today only, not the
entire workload. Persons under stress frequently jump from one activity to another, never
completing anything, and worrying about all that has to be done. This time wasting
process is controlled somewhat by carefully writing things down and working on them
one at a time.
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A more troublesome aspect to time management is to control what we have to do
and the general pace of our lives. How do you realistically say, "don't do so much," to a
single parent who is trying to work, go to school, manage a house, and provide emotional
support for young children? The psychological message received by a person in this kind
of stressful situation is, "I can't handle the job and I am inadequate." But the pacing of
one's life has to be addressed. The starting point is much like that of changing diet and
exercise, begin with awareness of what is really happening. Have the person keep a diary
of what they are doing:
DAILY ACTIVITY LOG
Day and Date___________________________
Activity
Comments
Morning:
Afternoon:
Evening:
Have the student keep the log for an agreed upon time period, usually a week, then go
through the list and attempt to divide the activities into categories something like the
following:
1. Things that have to be done, and only I can do them.
2. Things that have to be done, but possibly someone else could do them or help
with it.
3. Things I would really like to do, but probably could be discontinued.
4. Things I would really like to do, but can be postponed until a later time (like the
end of the semester).
5. Things that are not essential and should be discontinued.
59
One of the hurdles of breaking down activities into categories like the above is
that some will have to be given up or turned over to another person. That other person
will not do it in the same manner. For example, doing the laundry. I recall a test anxious
student who was having a particularly hard time managing things near the end of a
semester. We listed regular activities and one time saving suggestion I made was to let
her oldest daughter take over the duty of doing the laundry, at least until the semester was
over. I was given this incredulous look and told, "I can't do that. That is my duty as a
mother. And besides, she doesn't do a very good job of it." Having her daughter do it in
her mind would lessen her value to her family, because nobody could do it was well as
she. After talking longer she realized that her family didn't value her most because she
did the laundry, but because of the person she was. The family wanted her to succeed and
would do anything to help her achieve her goal. Changing the pacing means letting go
and changing how we view ourselves.
There are two additional coping skills that appear to help control life pacing:
relabeling, and renegotiating. Relabeling refers to the ability to change how we view
things. The trite phrase, "If life gives you lemons, make lemonade," probably expresses it
as well as anything. Some people seem to have this wonderful personal perspective to
not let things bother them and make the best of every situation. How do you teach that to
others? It is probably the result of years of upbringing and habituation, so changing from
a negative view of things to a positive is not an easy task. About the only way to begin
the
process of change is to consciously look at life situations and brainstorm alternatives. For
example, a teacher assigns a research paper on a subject for which a student has little
previous knowledge. The initial reaction might be, "How can he do this? I don't know
anything about this, I can't do a decent paper on it." A relabeling of this situation would
be to consciously say to yourself, "It's something entirely new. It will take extra time to
do research, but I'll really learn a lot." I regularly have students complete a simple writing
activity:
60
Describe a recent stressful situation:
How did you react, what did you say to yourself?
What are some different ways you could have reacted, or things you could have said to
yourself?
By completing questions such as these over a variety of stressful situations, the
student can begin to see a pattern of reacting and possibly begin practicing different
approaches. But realistically it takes a long time and considerable practice to change the
habitual ways of viewing things.
Renegotiating refers to a conscious attempt to discuss the "rules" of social and
family situations. For example, a woman returns to school after ten years of caring for
young children and managing the day to day operation of the household. During that time
period she prepared nearly all the family meals, did the majority of the cleaning and
laundry, and was the primary chauffeur for getting children to all their activities. The
entire family was aware of her plan to go to school and voiced full support for the plan.
But now that school has started dinners are later and more often simpler; favorite outfits
are in the dirty clothes, not hanging in the closet; sometimes no one is around to drive a
child to school activity; Mom is feeling frazzled, and everyone acts angry. What
happened? The situation changed, but the unwritten rules of family operation had not,
everyone was still expecting Mom to do the same things as always. This family can
benefit from a family meeting where the feelings about Mom going to school can be
discussed, and home responsibilities renegotiated. Things need to be brought out in the
open, not left unsaid to have angry feelings develop. This type of renegotiating will give
the student more time, plus will leave her feeling less guilty about what is happening-thus making it less stressful.
Summary
There are many ways to manage stress and abundant resources to learn how to do
it, this chapter certainly cannot be considered a comprehensive summary of stress
management and users should not limit themselves to the areas mentioned here. It did,
however, attempt to highlight three areas that appear to greatly affect school anxious
students: Diet and Eating Patterns, Exercise, Time Management and Life Pacing.
61
Selected References:
Feuerstein, M.; Labbe, E.; Kuczmierczyk, A. Health Psychology: A Psychobiological
Perspective. Plenum Press: New York, 1986.
Manahan, W. Eat for Health: A Do-It-Yourself Nutrition Guide for Solving Common
Medical Problems. H.J. Kramer: Tiburon, CA, 1988.
Selye, H. Stress Without Distress. J.B. Lippencott: Philadelphia, 1974.
Teplitz, J. Managing Your Stress: How to Relax and Enjoy. Happiness Unlimited:
Virginia Beach, VA, 1985.
Tubesing, D. Kicking Your Stress Habits. Whole Person Associates: Duluth, MN, 1981.
62
CHAPTER SEVEN
MODEL PROGRAMS FOR TEST, SPEECH AND MATH ANXIETY
The purpose of this chapter is to outline the recommended elements of programs
for the treatment of particular school anxieties. The ones selected for expanded treatment
are: Test Anxiety, Speech Anxiety (Communication Apprehension), and Math Anxiety.
These three were selected simply because of the sheer volume of students who fit into
these categories. It does not mean one should totally ignore other types of school
anxieties such as: Science Anxiety, Computer Anxiety, Stage Fright, Writing Anxiety, or
the Fear of Returning to School. However, the basic models of any of these anxieties can
be adapted to other types of concerns. And in fact the particular program model used
should be indigenous to an individual school. One assumption made by this author is that
group approaches are generally better than individual. The reason for this assumption is
two fold:
1.) In school settings it is more efficient to use a group
2.) The natural support found in a group is very beneficial for the development of
positive attitudes and helps facilitate actual behavioral change. A full
demonstration of the use of these models is found in the test and speech
anxiety workbooks.
The program recommendations are based upon the experiences of this author
along with consultations with a number of different practitioners at various other
colleges. They are biased by the particular needs of the schools who prepared the
programs, so please adapt them to your situation. One common adaptation is to use a
team approach, since not every counselor or teacher is skilled in all areas. Some of the
references used
and the contact persons are listed at the close of this chapter.
Test Anxiety
Of all the various school anxieties, Test Anxiety is the most ubiquitous. Nearly
every student in high school and college has experienced some form of test anxiety
because tests are an integral part of our educational system--they cannot be avoided. It is
63
because they cannot be avoided that most students are able conquer their fears and learn
to perform adequately. But as we know many do not.
Test anxiety is also so prevalent because it masks other problems, notably poor
study skills and habits. But it also can be the result of other factors, such as: math or
science anxiety, excessive stress, or a low self-esteem. The test anxiety is continually
being reinforced in the student because of frequent tests and persistent failure. It is
because of the multiple faces of test anxiety, that this author recommends that you assume
that for any given student there are multiple causes for the test anxiety, and that all
students receive assorted behavioral and cognitive treatments. There may be some
elements of the program that certain students do not need as much as others, but that is
the risk of a group method. The following are the elements that should be included in a
comprehensive test anxiety program:
A.) Information on the nature of anxiety.
B.) Assistance in the development of study skills.
C.) Test taking skill instruction and practice at taking tests.
D.) Information and goal setting on a healthy lifestyle.
E.) Cognitive restructuring.
F.) Anxiety management techniques.
G.) Systematic Desensitization.
It is possible to change the emphasis and time spent in each of these segments,
depending upon the needs of your particular students. They need not be presented in the
the above sequence. It is best to intertwine the units so that activities from each segment
are repeated several times (model good learning theory as well as teach it.) The one
element that is probably least necessary is the systematic desensitization. The majority of
the anxiety is eliminated for most test anxious students once they have learned to improve
their study habits, take tests, and start living a healthier lifestyle. But the students
generally like doing the desensitization because it feels good and they receive very
immediate feedback on their progress. Let me expand on the suggested elements:
A.) Information on the nature of anxiety. At times students are fearful that
something is dreadfully wrong with themselves, or that they may have a serious organic
problem. Knowing a little about what happens within their bodies is often reassuring.
For example, many students report "going blank" while taking a test. It provides great
relief to know that it is partially a result of sympathetic arousal. When your body is in a
very excited state it shuts down certain organs or functions so that you can "run fast and
jump high." One system that is impaired during strong arousal are higher brain functions
(reduced blood flow). So by controlling the physical reaction, you can think better. The
background information on anxiety helps set the groundwork for activities that students
will be doing as part of the test anxiety reduction program.
B.) Assistance in the development of study skills. This is an absolutely essential
element, because unless the student has learned the material to begin with, no amount of
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test anxiety reduction will help. A student who is very calm will still not pass a test if he
or she does not know the material. The following skills in particular seem to help:
making a study calendar so students have no surprises and will focus on today, utilizing
active reading techniques, and getting in the habit of constant review.
C.) Test taking skill instruction and practice at taking tests. Although this is really
a sub-set of the study skills area, is deserves special mention. By teaching students some
of the "tricks" of taking tests and by having them actually practice, you are conducting "In
Vivo" desensitization. It is an excellent check of effective study as well as a way to make
actual test situations less frightening.
D.) Information and goal setting on a healthy lifestyle. Many counselors consider
this a peripheral subject to school performance, my experience has taught me otherwise.
Students do not operate in a vacuum, and what is happening in their lives and how they
take care of their bodies will impact performance. With test anxious students diet in
particular seems to be a factor. Many students state that they do not eat the morning of a
test because they are too nervous and are afraid they will vomit, but that is precisely why
they need to eat. Students are amazed at how quickly they can modify their feelings by
changing how they eat and take care of themselves.
E.) Cognitive Restructuring. Years of poor performance in school settings will
take its toll on belief systems. Students get down on themselves and work against their
own success. Relatively simple work in analyzing self-talk and coming up with more
positive and planned self-statements will serve as an excellent supplement to the other
elements of the program.
F.) Anxiety Management Techniques. What is meant by this is teaching students
deliberate strategies of how to cope when they are experiencing anxiety, including: quick
relaxation methods using diaphragm breathing, engaging in relaxing activities just prior
to a test, taking a break to get a drink of water during a test, skipping problems within a
test, etc. This also serves as a form of "In Vivo" desensitization.
G.) Systematic Desensitization. As mentioned earlier, this is probably the least
essential element of the program, but also the most popular. It feels good, and students
like the results. The deep muscle relaxation method taught during desensitization helps
student acquire skill at the quick relaxation methods used for anxiety management. It can
be conducted individually, in a group, or by audio tape. The audio tape method is
convenient and effective, but the "live" group approach creates a relaxed and supportive
atmosphere for other group activities. This author likes to run a one-hour group with a
half-hour of instruction followed by the desensitization.
In summary, it is best to give test anxious students a very broad based program
because the anxiety frequently comes from multiple sources. A combined cognitive and
behavioral approach is likely to meet the needs of most students.
65
Speech Anxiety or Communication Apprehension
The term "speech anxiety" normally encompasses the fears of students to get up in
front of a group and talk, whether that be a formal public speaking activity or simply to
talk to the members of a class. "Communication Apprehension" is a much broader term
that includes speech anxiety, but also includes the reticence to participate in a small group
discussion or even talk one-on-one. The speech anxiety is the more dramatic and visible,
while certain elements of communication apprehension may be more subtle and harder to
detect. The communication apprehension may be at the root of the problem when
instructors report that they have a hard time getting class discussions going or that
students lack assertiveness and never come to them with questions.
The majority of this section deals with the speech anxiety component of
communication apprehension, because that is generally the reason for a request for
assistance by the student. Students (or faculty referrals) come because they are having
severe anxiety problems while speaking to groups. The one-to-one or small group
discussion fears are probably just as prevalent, but the persons don't come forward to seek
help as readily as those with public speaking fears. Persons with an interest in addressing
the general communication apprehension issue will need to "go after" the students
through an assessment/identification process and encourage them to seek assistance. The
Personal Report of Communication Apprehension (PRCA-24) is the most commonly
cited assessment tool because it breaks the scores down into ones for: Group discussion,
Meetings, Interpersonal conversations, and Public speaking (Richmond and McCroskey,
1989). Some additional references along these lines are found at the end of this chapter.
This author owes thanks to Dr. Arden Watson of Pennsylvania State University-Delaware
County Campus for clarifying the importance of this difference and providing an
excellent model.
In contrast to test anxiety which seems to be more general, speech anxiety tends to
be more individual and unique. A student may be functioning well in the vast majority of
school arenas, yet totally fall apart when they have to talk to a group. In some cases it is
only particular types of groups; the student may be okay when talking to peers, but has
trouble when the teacher is in the room. Also in contrast to the test anxiety, the speech
anxiety is more easily avoided. It is possible to go through an entire college (or working)
career without having to do public speaking. As I counselor at a community college I
know of students who would select a particular career program or transfer school based
on whether or not public speaking was required. But remaining like this throughout ones
life can be seriously limiting both personally and professionally.
The literature and experts (Richmond and McCroskey, 1989; Kelly and Watson,
1986; Watson, 1986) point to three areas for treatment:
A.) Skills Training.
B.) Cognitive Restructuring.
66
C.) Systematic Desensitization.
Unlike the test anxiety, students may or may not receive treatment in all three of
the areas. It is possible to focus on the particular needs of the student and only have him
or her work in the area(s) required.
A.) Skills Training. This is the traditional, and most common treatment for
speech anxiety. In schools, it is generally what is taught in speech and communication
classes. Students learn how to: research and organize, analyze the audience, speak
clearly, etc. They are given practice at speaking in a relatively relaxed atmosphere where
all students are "in the same boat" and they support each other. Students are taped and
can hear and/or see themselves. Watson (1986) uses the approach of having students set
specific communication goals as a way to work toward the accomplishment of particular
communication skills. For many students this step alone is sufficient to deal with the
anxiety, and the practice speeches serve as an "in vivo" desensitization. Anxiety
management techniques such as deep breathing and focusing the nervousness into
speaking energy can be considered skill development activities.
B.) Cognitive Restructuring. Using the basic Ellis model, students can be taught
to recognize their irrational beliefs surrounding communication, and then consciously
dispute those believes. So many of the irrational beliefs revolve around self and what
will happen in these communication situations. Students with long standing speech
anxieties are likely to have a powerful set of negative cognitions.
C.) Systematic Desensitization. As with the test anxiety, the students respond
favorably to the systematic desensitization process because they enjoy the relaxation, and
it does serve to facilitate the student's ability to relax before and during a speech. It may
be a little harder to develop an "average" hierarchy to use with a group or on audio tapes,
because some of the fears are so specific. But as long as the students can remain
reasonably flexible, it is still quite advisable to conduct the desensitization in a group or
by tape.
In summary, the speech anxiety tends to be a little more specific than the test
anxiety, but the fundamental model still holds.
67
Math Anxiety
Mathematics Anxiety is also quite different from general test anxiety because the
fears seem to be so compartmentalized to math. The student will frequently be doing fine
in everything except math or subjects requiring extensive math like Chemistry or
Economics. The reason for referral for assistance may be labeled test anxiety, but in
reality the test anxiety is only found with mathematics. These students can benefit from a
test anxiety program, but special additions are needed to address the issues specific to
mathematics.
One confounding factor is that the vast majority of students expressing math
anxieties are women. For a variety of reasons that are widely discussed in the literature,
women are apparently not given adequate support to develop the skills and attitude to be
successful in mathematics. There is the acceptance of the myth, "I don't have the mind
for math." Many men also suffer from the same affliction, but at the college level most
students who express that they have math anxiety are female (maybe the men just don't
express it as well). The implications of this in terms of career potential are staggering,
since many of the higher paying careers require complex mathematical skills. It is for this
reason that math anxiety has gotten a lot of attention and is well researched. Numerous
texts of excellent quality are available, and some are listed among the selected references.
Several areas are consistently included in programs for the reduction of math anxiety:
A.) Skill Development in Fundamental Mathematics.
B.) Group Support.
C.) Cognitive Restructuring.
D.) Test Anxiety Reduction.
A very wide range of delivery methods are used from individual tutoring to
supportive activities in classes of 20-30 students. Sometimes the instruction is by a math
teacher, sometimes a counselor. The most comprehensive models tend to use a team
taught approach with a supportive math teacher and a mathematically inclined counselor.
But group instruction is by far the most popular approach as is seen when elements of a
successful program are further explained:
A.) Skill Development in Fundamental Mathematics. The math avoidance
behavior found in college students usually started early in their school career. So while
some students were getting well grounded in fundamental mathematical skills, these
students were already avoiding math and not developing the essential basic skills. So the
first step is a realistic assessment of what the student can and cannot do, and beginning
the instruction at that level. Some college programs will even go back to teaching
methods used in elementary school programs, such as: the use of manipulatives to help
students make the bridge from concrete to abstract operations. Graphing calculators help
with this as well. At the community colleges which are the entry point for most adult
learners, pre-college level mathematics courses are usually filled to capacity. A student
may have been able to get into a higher level mathematics course only to discover that he
68
or she is missing some essential skills. It is difficult to take a step back into a lower level
class, especially if it means delaying the completion of a degree, but it is next to
impossible to remediate a person in mathematics while they are taking the course for
which they lack the skills.
B.) Group Support. Nearly all the successful programs for reducing math anxiety
had some elements of a support group, some even calling them "math anxiety support
groups." A number of things are accomplished by using group support: students no
longer feel isolated and that they are the only one with that problem, attitudes and beliefs
about oneself must be changed and the encouragement of others helps, helpful study
strategies can be shared, study groups can be formed to work on specific class
assignments.
C.) Cognitive Restructuring. Using the Ellis model rational/irrational thinking
can be explored and disputed. But one approach particular to mathematics is to dispute
some of the myths surrounding the learning of mathematics. These include: "Math
requires logic, not intuition." "You must always know how you got the answer." "There is
a best way to do a math problem." "Mathematicians do problems quickly, in their
heads." "Some people have a 'math mind' and some don't." (Kogelman and Warren,
1978). By working through a few sample problems students can be taught that math is
not such an exacting science as they are lead to believe and can learn to use intuitive
procedures to solve problems. This often gives the math anxious student "permission" to
experiment with math and significantly reduces the apprehension.
D.) Test Anxiety Reduction. Many of the same things used for general test
anxious students can be used here, or the students can participate in a test anxiety
reduction program as well. Some of the particular items that may be helpful include:
improving basic study skills, test taking skills, practice testing, diet and lifestyle
management, anxiety management techniques, and systematic desensitization.
Summary
In summary, the elements of model programs for the reduction of test, speech and
math anxiety were presented. All three approaches use basically the same components of
learning new skills, changing attitudes and beliefs, and systematic desensitization. These
same elements can be used to structure the treatment of other school anxieties. The
student workbooks for the reduction of test and speech anxiety included as part of this
program may serve as useful guide for the development of an anxiety reduction group.
69
Selected References
Baylis, C. The Mathophobia Workshop: A Strategy for Developing Mathematical
Readiness for the Academically Disadvantaged Student in Career
Education. EDRS # 180-522, June 1979.
Cohen, M. C. An Overcoming Speech Anxiety Course for the Community. EDRS
# 232-226, April 1983.
Crouse, R.; Deffenbacher, J.; Frost, G. Desensitization for Students with Different
Sources and Experiences of Test Anxiety. Journal of College Student
Personnel. July 1985, p.315-318.
Deffenbacher, J. L.; Parks, D. H. A Comparison of Traditional and Self-Control
Desensitization. Journal of Counseling Psychology. 1979, 26(2), p.93-97.
Goldfried, M.; Linehan, M. M.; Smith, J. L. Reduction of Test Anxiety Through
Cognitive Restructuring. Journal of Consulting and Clinical Psychology.
1978, 46(1), p.32-39.
Hackworth, R. Math Anxiety Reduction. H & H Publishing: Clearwater, FL,
1985.
Hembree, R. Correlates, Causes, Effects and Treatment of Test Anxiety. Review
of Educational Research.1988, 58(1), p.47-77.
Hodges, D. How to Lower Your Anxiety about Tests: An Edited Transcript of an
Audio Tape for College Students--With Outline and Introductory
Comments. EDRS #245-758, 1984.
Kelly, L.; Watson, A. K. Speaking with Confidence and Skill. University Press of
America: Lanham, MD, 1986.
Kogelman, S.; Warren, J. Mind Over Math. Dial Press: New York, 1978.
Kostka, M. P.; Wilson, C. K. Reducing Mathematics Anxiety in NontraditionalAge Female Students. Journal of College Student Personnel. 1986, 27(6),
p.530-534.
Mallow, J. V. Science Anxiety: Fear of Science and How to Overcome It.
Thomond Press: New York, 1981.
Melanson, D. Applied Self-Statement Modification and Applied Modified
Desensitization in the Treatment of Speech Anxiety: The Synergy
Hypothesis. EDRS # 294-252, 1986.
Ottens, A. J. Coping with Academic Anxiety. Rosen Publishing Group: New
York, 1984.
Richmond, V. P.; McCroskey, J. C. Communication: Apprehension, Avoidance,
and Effectiveness. Gorsuch Scarisbrick Publishers: Scottsdale, AZ, 1989.
Russo, T. J. Multimodal Approaches to Student Test Anxiety. The Clearinghouse.
1984, 58(4), p.162-166.
Shodahl, S. A.; Diers, C. Math Anxiety in College Students: Sources and
Solutions. Community College Review. 1988, 12(2), p.32-36.
Silverman, E.; Hanna, J. Test Anxiety Reduction: Curriculum Guide. EDRS 289060, 1987.
Thompson, M. A Workshop: Coping with Writing Anxiety, EDRS #234 848,
1983.
70
Tobias, S. Succeed with Math. College Entrance Examination Board: New York,
1987.
Watson, A. K. Alleviation of Communication Apprehension: an Individualized
Approach. Texas Speech Communication. 1986, p.3-13.
Watson, A. K. Effects of Systematic Desensitization in the Alleviation of
Communication Apprehension. EDRS # 297-399,1988.
Persons Who Provided Information or Consultations:
Linda Brandt, Moraine Valley Community College, Palos Heights, Illinois
Linda Chapman, Lewis and Clark College, Godrey, Illinois.
Marlene Cohen, Prince George's Community College, Largo, Maryland.
Bev Evans, Illinois Central College, East Peoria, Illinois.
Ray Hembree, Andrian College, Andrian, Michigan.
Diane Kuehl, Rock Valley College, Rockford, Illinois.
Barb Larsen, University of Wisconsin-Parkside, Kenosha, Wisconsin.
Allen Ottens, Northern Illinois University, DeKalb, Illinois.
Susan Shodahl, San Bernardino Valley College, San Bernardino, California.
Merle Thompson, Northern Virginia Community College, Annandale, Virginia.
Phil Troyer, William Rainey Harper College, Palatine, Illinois.
Arlen Twedt, Des Moines Area Community College, Ankeny, Iowa.
Arden Watson, Pennsylvania State University-Delaware County, Media,
Pennsylvania.
71
CHAPTER EIGHT
RELAXATION AND DESENSITIZATION SCRIPTS
This chapter is simply a resource one. The following are several different scripts
that can be used by a counselor working with school anxious students. The are the same
scripts used on the audio tapes that go with the student workbooks. Counselors who wish
may simply record their own tapes. The first first script listed is the one for "anxiety
management" that students can use during or just prior to the moment of crisis. The
second script is the deep muscle relaxation method that is used with the systematic
desensitization. Finally a sample of test anxiety hierarchies are presented.
Anxiety Management Relaxation Script -- Deep Breathing
(About 2 minutes)
The following is a brief relaxation method to be used at times when you are experiencing
anxiety or just prior to an activity that is likely to produce anxiety. It should be practiced
many times until you are able to do it on your own. With repeated practice you can
achieve very deep levels of relaxation in a short period of time.
Begin by sitting in a chair with your arms comfortably at your side, hands in your
lap. You may wish to loosen your neck and shoulder muscles by rolling your head and
raising your shoulders several times..... close your eyes and let your head come forward
until it is resting comfortably.
Begin to focus on your breathing. Breathe slowly and
gently...inhaling through your nose and exhaling through your mouth ... As you breathe
in, concentrate on using your diaphragm ... as you breathe in you should notice your lower
chest and stomach expanding greatly all of your bodily tensions.
Continue this slow
and gentle breathing as long as necessary and notice that your muscles will become heavy
and your mind will clear. As you start to relax imagine that you are engaging in a
favorite relaxing activity: laying on the beach, sitting by a lake, listening to favorite
music, taking a bath. You choose the scene, make it comfortable and very relaxing.
When you are fully relaxed and ready to return, open your eyes and begin your
task.
Relaxation Script -- Deep Muscle
(15 Minutes)
72
To be used as the deep muscle relaxation segment for systematic desensitization.
Adapted from: Wolpe, J & Lazarus, A.A. Behavior Therapy Techniques. New York:
Pergamon, 1966.
Note to the Speaker: Speak slowly and deliberately, using lower voice tones. Baritone
and alto tones are better than tenor and soprano. Practice using a tape recorder several
times before using the relaxation script with your clients.
Do the relaxation in a dimly
lit, quiet room. It may be accomplished by sitting in a comfortable chair, or by lying flat.
Lying down is the preferred position.
Before I begin I would like you to take a few seconds to relax as much as you can
totally on your own.....
Settle back as comfortably as you can. Let yourself relax to the
very best of your ability....Now, as you relax like that, clench both fists, just clench your
fists tighter and tighter, and study the tension as you do so. Keep them clenched and feel
the tension in your fists, hands, forearms....and now relax. Let the fingers of your hands
become loose, and observe the contrast in your feelings...now let yourself go and try to
become more relaxed all over...Once more, clench your fists really tight...hold them, and
notice the tension again....Now let go, relax; your fingers straighten out, and you notice
the difference once more....Each time, pay close attention to your feelings when you tense
up and when you relax. Now straighten your arms, straighten them so that you feel the
most tension in the triceps muscles along the back of your arms, stretch your arms and
feel that tension...and now relax. Get your arms back into a comfortable position. Let the
relaxation proceed on its own. Your arms should feel comfortably heavy as you allow
them to relax...Straighten your arms once more so that you feel the tension in the triceps
muscles; straighten them. Feel the tension...and relax. Get your arms comfortable and let
them relax further and further. Continue relaxing your arms even further. Even when
your arms seem fully relaxed, try to go that extra bit further; try to achieve deeper and
deeper levels of relaxation.
Let all of your muscles go loose and heavy. Just settle back quietly and
comfortably. Wrinkle up your forehead now; wrinkle it tighter...and now stop wrinkling
your forehead, relax and smooth it out. Picture your entire forehead and scalp becoming
smoother as the relaxation increases... Now, close your eyes tighter and tighter...place all
of your tension in your eyes....and relax your eyes. Keep your eyes closed, gently,
comfortably, and notice the relaxation....Now clench your jaws, bite your teeth together;
study the tension throughout the jaws....relax your jaws now....learn to appreciate the
relaxation....Now press your lips together tighter and tighter....relax the lips. Note the
contrast between tension and relaxation. Feel the relaxation all over your face. The
relaxation progresses further and further....Now attend to your neck muscles. Press you
head back as far as it can go and feel the tension in the neck; roll it to the right and feel
the tension shift; now roll it to the left. Straighten your head and return to a comfortable
position, study the relaxation, let the relaxation really develop....Now shrug your
73
shoulders, pull them up and try to touch your ears. Hold the tension....drop your
shoulders and feel the relaxation. Neck and shoulders relaxed. Shrug your shoulders
again and move them around. Bring your shoulders up, forward, and back. Feel the
tension in your shoulders and in your upper back...drop your shoulders once more and
relax. Let the relaxation spread deep into the shoulders, right into your back muscles;
relax your neck and throat, and your jaws and other facial areas as the pure relaxation
takes over and grows deeper....deeper....ever deeper.
Relax your entire body to the best of your ability....feel that comfortable heaviness
that accompanies relaxation.... breathe easily...freely in and freely out. Notice how the
relaxation increases as you exhale. As you breathe out just feel that relaxation. Now
breathe right in, fill your lungs, inhale deeply and hold your breath....study the
tension...now exhale, let the walls of your chest grow loose and push the air out
automatically...continue relaxing and breathe freely and gently... feel the relaxation and
enjoy it ... with the rest of your body as relaxed as possible, fill your lungs again, breathe
in deeply and hold it again. That's fine, breathe out and feel the relief ... just breathe
normally. Continue relaxing your chest and let the relaxation spread to your back,
shoulders, neck and arms. Merely let go and enjoy the relaxation. Now pay attention to
your stomach muscles, make your stomach hard ... notice the tension ... and relax. Let the
muscles loosen and notice the contrast. Feel the general well being that comes when
you relax your stomach. Now draw your stomach in, pull the muscles right in and feel the
tension this way, now push out and feel the tension ... once more pull in and feel the
tension ... now relax your stomach fully ...Let the tensions dissolve as the relaxation
grows deeper, deeper, ever deeper. Each time you breathe out notice the rhythmic
relaxation both in your lungs and in your stomach ... notice thereby how your chest and
stomach relax more and more.
Try and let go of all contractions anywhere in your body ... all parts relaxing
further and further, ever deeper. Now relaxed as you are, I would like you to tense all
the muscles in your right leg. Hold it ... and now relax. Let the muscles loosen as the
relaxation takes over. Once more tighten the muscles of your right leg while the rest of
your body stays as relaxed as possible ... and now relax. Relaxing more and more, ever
deeper. Now push your right foot downwards away from your face. Feel the tension in
your arch, ankle ... now return your foot to a comfortable and relaxed position.
Now
while the rest of your body stays as relaxed as possible, tense the muscles of your left leg
... hold it ...and now relax. Simply let the relaxation develop. Once more tense the
muscles of your left leg ... and now relax ... relaxing more and more. Now, push your left
foot downwards away from your face. Feel the tension in your arch, ankle ... and now
relax your foot.
Keep relaxing like that for a while ... feel how heavy your muscles have become.
In a state of perfect relaxation, you would feel unwilling to move a single muscle. Think
about the effort that would be required to raise your right arm ... as you think about
raising your arm, notice if tensions may have crept in. If so let them go and relax your
arm more.
Now you can become twice as relaxed as your are right now merely by
74
taking two very deep breaths ... and slowly ... very slowly exhaling ... (wait 10 seconds).
Now relaxed as you are, I would like you to imagine your own neutral scene, something
for you that is comfortable and very relaxing.
Wait about 45 seconds, then introduce the first scene in the hierarchy. Have the client(s)
imagine the scene for 30 seconds, then say: "Stop imagining that and relax. Take a deep
breathe and go back to your neutral scene." Wait 30 seconds and reintroduce the first
scene. Have the client imagine the scene for 30 seconds, then say: "Stop imagining that
and relax." Repeat the same process for the second scene in the hierarchy. For
subsequent sessions repeat the last scene from the previous session, and introduce one
new and higher scene. If the client is having difficulty staying relaxed while visualizing
the scene, stay at the same level and do not introduce a new scene. After the last scene
say, "Stop imagining that and relax, keep relaxing like that for a while ... (wait 90-120
seconds) ... now I am going to count from one to four. When I say 'one' start wiggling
your toes, 'two' start moving your feet, 'three' start moving your hands, 'four' open your
eyes and sit up. One, start wiggling your toes ... Two, start moving your feet ... Three,
start moving your hands ... Four, open your eyes and sit up."
75
Script for Test Anxiety Hierarchy Audio Tapes
(To be combined with the deep muscle general relaxation script)
TAPE ONE
Test Anxiety Tape One.
This is the first of six tapes to be used for the reduction of test anxiety. For the relaxation
find a quiet, dimly lit room where you will not be disturbed. Sit in a comfortable easy
chair or lay in a prone position, generally lying flat is the best. After going through the
deep muscle relaxation you will first be asked to imagine something called a "neutral
scene." This is a mental picture of your favorite relaxing activity: lying on the beach,
listening to music, sitting by a lake, etc. After picturing your neutral scene you will be
asked to picture two different scenes related to test anxiety. The goal is to be able to stay
perfectly relaxed while imagining these scenes. When you can do this while staying
relaxed, you can go on to higher level anxiety producing scenes. Do not go on to tape
two until you can picture these scenes while staying relaxed. We are ready to begin.
(insert relaxation script)
Relaxed as you are, I would like you to imagine that you are at home studying.
(25 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, I would like you to imagine that you are at home studying.
(25 seconds)
Stop imagining that and relax.
(30 seconds)
Now relaxed as you are, I would like you to imagine that your instructor announces a test
in two weeks.
(25 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, I would like you to imagine that your instructor announces a test in two
weeks.
(25 seconds)
Stop imagining that and relax. Keep relaxing like that for a while, feel the relaxation and
enjoy it.
(90 seconds)
Now I am going to count from one to four. When I say one start wiggling your toes; two,
start moving your feet; three, start moving your hands; four, open your eyes and sit up.
One, start wiggling your toes. Two, start moving your feet. Three, start moving your
hands. Four, open your eyes and sit up.
76
TAPE TWO
Test Anxiety Tape Two.
This is the second of six tapes to be used for the reduction of test anxiety. For the
relaxation find a quiet, dimly lit room where you will not be disturbed. Sit in a
comfortable easy chair or lay in a prone position, generally lying flat is the best. After
going through the deep muscle relaxation you will first be asked to imagine something
called a "neutral scene." This is a mental picture of your favorite relaxing activity: lying
on the beach, listening to music, sitting by a lake, etc. After picturing your neutral scene
you will be asked to picture two different scenes related to test anxiety. The goal is to be
able to stay perfectly relaxed while imagining these scenes. When you can do this while
staying relaxed, you can go on to higher level anxiety producing scenes. Do not go on to
tape three until you can picture these scenes while staying relaxed. We are ready to
begin.
(insert relaxation script)
Relaxed as you are, imagine that your instructor announces a test in two weeks.
(25 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, imagine that your instructor announces a test in two weeks.
(25 seconds)
Stop imagining that and relax.
(30 seconds)
Now relaxed as you are, I would like you to imagine that you are trying to go to sleep the
night before a test.
(25 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, I would like you to imagine that you are trying to go to sleep the night before
a test.
(25 seconds)
Stop imagining that and relax. Keep relaxing like that for a while, feel the relaxation and
enjoy it.
(90 seconds)
Now I am going to count from one to four. When I say one start wiggling your toes; two,
start moving your feet; three, start moving your hands; four, open your eyes and sit up.
One, start wiggling your toes. Two, start moving your feet. Three, start moving your
hands. Four, open your eyes and sit up.
77
TAPE THREE
Test Anxiety Tape Three
(insert relaxation script)
Relaxed as you are, imagine that you are going to sleep the night before a test.
(25 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, imagine that you are going to sleep the night before a test.
(25 seconds)
Stop imagining that and relax.
(30 seconds)
Now relaxed as you are, I would like you are receiving back a graded test.
(25 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, I would like you to imagine that you are receiving back a graded test.
(25 seconds)
Stop imagining that and relax. Keep relaxing like that for a while, feel the relaxation and
enjoy it.
(90 seconds)
Now I am going to count from one to four. When I say one start wiggling your toes; two,
start moving your feet; three, start moving your hands; four, open your eyes and sit up.
One, start wiggling your toes. Two, start moving your feet. Three, start moving your
hands. Four, open your eyes and sit up.
78
TAPE FOUR
Test Anxiety Tape Four
(insert relaxation script)
Relaxed as you are, imagine that you are receiving back a graded test.
(25 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, imagine that you are receiving back a graded test.
(25 seconds)
Stop imagining that and relax.
(30 seconds)
Now relaxed as you are, I would like you to imagine you are entering class the day of a
test.
(25 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, I would like you to imagine that you are entering class the day of a test.
(25 seconds)
Stop imagining that and relax. Keep relaxing like that for a while, feel the relaxation and
enjoy it.
(90 seconds)
Now I am going to count from one to four. When I say one start wiggling your toes; two,
start moving your feet; three, start moving your hands; four, open your eyes and sit up.
One, start wiggling your toes. Two, start moving your feet. Three, start moving your
hands. Four, open your eyes and sit up.
79
TAPE FIVE
Test Anxiety Tape Five
(insert relaxation script)
Relaxed as you are, imagine that you are entering class the day of a test.
(25 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, imagine that you are entering class the day of a test.
(25 seconds)
Stop imagining that and relax.
(30 seconds)
Now relaxed as you are, I would like you to imagine you are reading the first question of
a test and skipping it because you cannot answer it.
(25 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, I would like you to imagine that you are reading the first question of a test
and skipping it because you cannot answer it.
(25 seconds)
Stop imagining that and relax. Keep relaxing like that for a while, feel the relaxation and
enjoy it.
(90 seconds)
Now I am going to count from one to four. When I say one start wiggling your toes; two,
start moving your feet; three, start moving your hands; four, open your eyes and sit up.
One, start wiggling your toes. Two, start moving your feet. Three, start moving your
hands. Four, open your eyes and sit up.
80
TAPE SIX
Test Anxiety Tape Six
(insert relaxation script)
Relaxed as you are, imagine that you are reading the first question of a test and skipping it
because you cannot answer it.
(30 seconds)
Stop imagining that and relax, take a deep breath and go back to your neutral scene.
(30 seconds)
Once more, imagine that you are reading the first question of a test and skipping it
because you cannot answer it.
(40 seconds)
Stop imagining that and relax. Keep relaxing like that for a while, feel the relaxation and
enjoy it.
(90 seconds)
Now I am going to count from one to four. When I say one start wiggling your toes; two,
start moving your feet; three, start moving your hands; four, open your eyes and sit up.
One, start wiggling your toes. Two, start moving your feet. Three, start moving your
hands. Four, open your eyes and sit up.
****************************************************************
A Sample is not provided for Speech or other anxieties because
the format is essentially the same. Develop a heirarchy and
insert the scenes in a similar manner.
****************************************************************
81
CONCLUSION
In chapter one school anxiety was defined as, "a strong physical and psychological
reaction to specific situations in school that seriously impairs the ability of the student to
perform." The general term school anxiety was selected because the various sub-types
(test, speech, math, etc.) share some common elements and treatments.
It is the "marriage" of behavior therapy, cognitive therapy, and traditional
classroom instruction that constitutes effective treatment of school anxiety. The text
attempted to briefly outline the critical areas such as study skills, systematic
desensitization, and cognitive treatments in a manner that a relatively experienced
educator could take them and directly apply the concepts. If these aren't adequate "how
to" materials, the appendices should be consulted. One appendix lists scripts that can be
used to conduct systematic desensitization, others give complete student workbooks for
test and speech anxiety groups. They are prototypes of the instructional materials used in
a self-paced class taught at the College of Lake County. A separate Math Anxiety
workbook was not developed since there are a number of very good instructional based
materials available.
A final note relates to the satisfaction of working with school anxious students. It
really feels fantastic to observe someone make a dramatic turn around, and knowing that
your efforts had a direct impact on that. Too frequently our efforts take years to take hold
and the students have left the institution before we know what has happened to them.
With the school anxious student you get an opportunity to receive some concrete
feedback. A hug from a grateful student on graduation day can keep you going for a long
time.
Good luck!
82
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Thompson, M. (1983) A Workshop: Coping with Writing Anxiety, EDRS #234 848.
Thompson, M. (1979) Writing Anxiety and Freshman Composition, EDRS #183-235.
Tobias, S. (1987) Succeed with Math. College Entrance Examination Board: New York.
Tubesing, D. (1981) Kicking Your Stress Habits. Whole Person Associates: Duluth,
Minnesota.
Watson, A. (1988) Effects of Systematic Desensitization in the Alleviation of
Communication Apprehension, EDRS # 297-399.
Watson, A. (1986) Alleviation of Communication Apprehension: An Individualized
Approach. Texas Speech Communication, 3-13.
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Wilson, R. R. (1986) Don't Panic: Taking Control of Anxiety Attacks. Harper and Row:
New York.
Wise, E. H. and Haynes, S. N. (1983) Cognitive Treatment of Test Anxiety: Rational
Restructuring versus Attentional Training. Cognitive Therapy and Research, 7(1),
69-78.
Wolpe, J. (1982) The Practice of Behavior Therapy, Third Edition Pergamon: New York.
Wolpe, J. (1981) Our Useless Fears.Houghton Mifflin: NY.
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MATERIALS THAT CAN BE ORDERED FROM THE COLLEGE
OF LAKE COUNTY
The following are materials that can be ordered from the College of Lake County. To
obtain a current price list please contact:
Dr. David Ross
Counseling Center
College of Lake County
19351 W. Washington St.
Grayslake, IL 60030-1198
708-223-6601 ext. 2352
Test Anxiety Student Set. A workbook using a multi-dimensional approach to reducing
test anxiety. It can be the text for an on-going group or as part of a self-paced program.
This includes a six step systematic desensitization sequence on audio tape.
Speech Anxiety Student Set. Similar to the test anxiety workbook and tapes, with the
focus on public speaking.
Ten Steps to Reducing Test Anxiety. A 12-minute video designed for use with class
presentations or workshops. Includes a discussion guide.
General Relaxation Tape. An audio tape with instructions for a brief deep breathing
relaxation method on one side, and a 15 minute deep muscle relaxation method on the
other.
Desensitization Tapes. The relaxation and desensitization tapes that correspond to the
student workbooks can be ordered separately.
Staff Consultations and Training. Dr. Ross is available for on-site training or
consultations. Contact him directly for information.
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